Provider Demographics
NPI:1790505493
Name:SALTARES, SELENA DENISE (MSW)
Entity type:Individual
Prefix:MS
First Name:SELENA
Middle Name:DENISE
Last Name:SALTARES
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82 WHITEHOUSE DR APT 1
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-5344
Mailing Address - Country:US
Mailing Address - Phone:585-309-2301
Mailing Address - Fax:
Practice Address - Street 1:450 HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14610-1114
Practice Address - Country:US
Practice Address - Phone:585-482-4836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool