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General NPI Number Information
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NPI Number | 1457621971
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Entity Type | Individual
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Provider Name | SASHA SHOHREH SALAMIAN MS, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 01/02/2012
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Last Update Date | 01/02/2012
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Provider Practice Location Address
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Address Line | 4437 S CICERO AVE
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City | CHICAGO
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State | IL
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Zip | 60632-4333
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Country | US
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Telephone | 773-884-0484
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 N LAKE SHORE DR APT 12G
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City | CHICAGO
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State | IL
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Zip | 60610-1680
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Country | US
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Telephone | 512-771-7598
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 103856
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146.010626
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License Number State | IL
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