Provider Demographics
NPI:1750892410
Name:SALTZBERG, BETSIE (M ED)
Entity type:Individual
Prefix:
First Name:BETSIE
Middle Name:
Last Name:SALTZBERG
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 BREMERTON RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44124-5343
Mailing Address - Country:US
Mailing Address - Phone:216-337-7457
Mailing Address - Fax:
Practice Address - Street 1:3030 BREMERTON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44124-5343
Practice Address - Country:US
Practice Address - Phone:216-337-7457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-19
Last Update Date:2017-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP280103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool