Healthcare Provider Details

I. General information

NPI: 1588745806
Provider Name (Legal Business Name): CARRIE MARIE SALAZAR MC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 E WATSON DR
TEMPE AZ
85283-3147
US

IV. Provider business mailing address

1600 E WATSON DR
TEMPE AZ
85283-3147
US

V. Phone/Fax

Practice location:
  • Phone: 480-897-6063
  • Fax: 480-838-0853
Mailing address:
  • Phone: 480-897-6063
  • Fax: 480-838-0853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: