Healthcare Provider Details

I. General information

NPI: 1285352807
Provider Name (Legal Business Name): ROSA SALAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2022
Last Update Date: 08/19/2022
Certification Date: 08/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 6TH ST SE
CEDAR RAPIDS IA
52401-1903
US

IV. Provider business mailing address

2210 LINCOLN WAY
AMES IA
50014-7106
US

V. Phone/Fax

Practice location:
  • Phone: 319-364-7121
  • Fax:
Mailing address:
  • Phone: 515-296-2759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: