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General NPI Number Information
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NPI Number | 1235303942
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Entity Type | Individual
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Provider Name | MICHELLE SALAZAR LISW-S
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Gender | Female
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Dates
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Enumeration Date | 04/15/2008
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 401 E. MARKET ST
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City | CELINA
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State | OH
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Zip | 45822-1736
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Country | US
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Telephone | 419-584-5123
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Fax | 567-890-7214
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Provider Business Mailing Address
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Address Line | 401 E. MARKET ST
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City | CELINA
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State | OH
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Zip | 45822-1736
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Country | US
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Telephone | 419-305-7214
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Fax | 567-890-7214
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | I.0007811-SUPV
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I.0007811.SUPV
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License Number State | OH
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