Provider Demographics
NPI:1841439114
Name:SALTON, LORI ANNE CROSSETTA
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANNE CROSSETTA
Last Name:SALTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:LORI
Other - Middle Name:ANNE
Other - Last Name:CROSSETTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:295 INGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1439
Mailing Address - Country:US
Mailing Address - Phone:585-802-7067
Mailing Address - Fax:
Practice Address - Street 1:41 COLEBROOK DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14617-2211
Practice Address - Country:US
Practice Address - Phone:585-467-4567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY471476041103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool