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General NPI Number Information
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NPI Number | 1194944256
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Entity Type | Individual
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Provider Name | DEBBIE IRENE SALAZAR LISW
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 07/03/2014
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Provider Practice Location Address
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Address Line | 208 B. RANCHITOS
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City | TAOS
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State | NM
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Zip | 87571
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Country | US
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Telephone | 505-603-8720
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Fax |
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Provider Business Mailing Address
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Address Line | 108 B. SIERRA VISTA LANE
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City | TAOS
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State | NM
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Zip | 87571-6632
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Country | US
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Telephone | 505-603-8720
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I-08682
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License Number State | NM
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