Healthcare Provider Details

I. General information

NPI: 1619888435
Provider Name (Legal Business Name): DIANA MARIE SALAZAR LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 PIERCE ST
CHELSEA MI
48118-1234
US

IV. Provider business mailing address

3334 ARROW PASS
PINCKNEY MI
48169-9231
US

V. Phone/Fax

Practice location:
  • Phone: 734-433-2205
  • Fax:
Mailing address:
  • Phone: 517-605-4123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number6801089724
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: