Healthcare Provider Details

I. General information

NPI: 1356291934
Provider Name (Legal Business Name): MARIANITA SALAIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 02/02/2026
Certification Date: 02/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6345 REYNOLDS DR # B7 B7
LAS CRUCES NM
88011-6835
US

IV. Provider business mailing address

6345 REYNOLDS DR # B7
LAS CRUCES NM
88011-6835
US

V. Phone/Fax

Practice location:
  • Phone: 575-288-1672
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: