Provider Demographics
NPI:1780137257
Name:SALESKI, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:SALESKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 EDGEWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1844
Mailing Address - Country:US
Mailing Address - Phone:586-823-8314
Mailing Address - Fax:
Practice Address - Street 1:2310 EDGEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1844
Practice Address - Country:US
Practice Address - Phone:586-823-8314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIS4202290673592255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer