Provider Demographics
NPI:1649548785
Name:SALJA-MOTA, ROSA M (LMFT)
Entity type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:M
Last Name:SALJA-MOTA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ROSA
Other - Middle Name:
Other - Last Name:MOTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:6485 EVERINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-6431
Mailing Address - Country:US
Mailing Address - Phone:407-616-4620
Mailing Address - Fax:
Practice Address - Street 1:2500 W LAKE MARY BLVD STE 103
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-3501
Practice Address - Country:US
Practice Address - Phone:407-616-4620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-04
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2455106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist