Healthcare Provider Details

I. General information

NPI: 1295444511
Provider Name (Legal Business Name): SALAMON SPEECH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2022
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3219 MISSOURI AVE
LAS CRUCES NM
88011-4838
US

IV. Provider business mailing address

3219 MISSOURI AVE
LAS CRUCES NM
88011-4838
US

V. Phone/Fax

Practice location:
  • Phone: 575-805-0330
  • Fax:
Mailing address:
  • Phone: 575-805-0330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JUDY SALAMON
Title or Position: OWNER
Credential: CCC-SLP
Phone: 575-201-3822