Healthcare Provider Details

I. General information

NPI: 1831017920
Provider Name (Legal Business Name): DENISSE SALAZAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1141 MALL DR STE E
LAS CRUCES NM
88011-8194
US

IV. Provider business mailing address

1141 MALL DR STE E
LAS CRUCES NM
88011-8194
US

V. Phone/Fax

Practice location:
  • Phone: 575-522-0660
  • Fax: 575-522-3151
Mailing address:
  • Phone: 575-522-0660
  • Fax: 575-522-3151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCTB-2026-0501
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: