Healthcare Provider Details

I. General information

NPI: 1346308285
Provider Name (Legal Business Name): LINDA SALOMONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LINDA SALOMONE PH.D.

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1639 BETTS ST NE
ALBUQUERQUE NM
87112-4267
US

IV. Provider business mailing address

PO BOX 13012
ALBUQUERQUE NM
87192-3012
US

V. Phone/Fax

Practice location:
  • Phone: 505-292-9071
  • Fax:
Mailing address:
  • Phone: 505-292-9071
  • Fax: 505-275-7184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0045
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: