Provider Demographics
NPI:1457518334
Name:SALAZAR, DENORA ORTIZ (LPC INTERN)
Entity type:Individual
Prefix:MS
First Name:DENORA
Middle Name:ORTIZ
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 THORNWOOD ST
Mailing Address - Street 2:P.O. BOX 3754
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78574-2378
Mailing Address - Country:US
Mailing Address - Phone:956-585-8096
Mailing Address - Fax:956-585-8096
Practice Address - Street 1:509 S CLOSNER BLVD
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4659
Practice Address - Country:US
Practice Address - Phone:956-537-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63745101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health