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General NPI Number Information
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NPI Number | 1629282686
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Entity Type | Individual
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Provider Name | DONNA JEAN SALAZAR M. ED., LBA, LISAC
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 07/28/2023
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Provider Practice Location Address
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Address Line | 705 N OLIVE AVE
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City | CASA GRANDE
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State | AZ
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Zip | 85122-4034
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Country | US
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Telephone | 520-840-0697
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Fax | 520-635-5331
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Provider Business Mailing Address
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Address Line | PO BOX 562
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City | FLORENCE
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State | AZ
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Zip | 85132-3010
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Country | US
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Telephone | 520-840-0697
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Fax | 520-635-5331
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LISAC-11747
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BEH-000773
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License Number State | AZ
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