Healthcare Provider Details

I. General information

NPI: 1336453695
Provider Name (Legal Business Name): NICHOLAS L SALSMAN PH.D., ABPP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2010
Last Update Date: 07/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 VICTORY PKWY
CINCINNATI OH
45207-6511
US

IV. Provider business mailing address

3800 VICTORY PKWY
CINCINNATI OH
45207-6511
US

V. Phone/Fax

Practice location:
  • Phone: 513-745-4289
  • Fax: 513-745-3327
Mailing address:
  • Phone: 513-745-4289
  • Fax: 513-745-3327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6380
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: