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General NPI Number Information
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NPI Number | 1124682059
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Entity Type | Individual
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Provider Name | BOBBY JO SALM MSW
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Gender | Female
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Dates
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Enumeration Date | 04/25/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 1061 COURT AVE
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City | MARENGO
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State | IA
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Zip | 52301-1439
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Country | US
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Telephone | 319-361-6529
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Fax |
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Provider Business Mailing Address
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Address Line | 513 REDBIRD RUN
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City | TIFFIN
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State | IA
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Zip | 52340-9309
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Country | US
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Telephone | 319-330-7227
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 095401
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License Number State | IA
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