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General NPI Number Information
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NPI Number | 1669126108
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Entity Type | Individual
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Provider Name | SARA E SALEM LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/03/2022
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Provider Practice Location Address
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Address Line | 5806 MESA DR STE 305
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City | AUSTIN
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State | TX
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Zip | 78731-3783
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Country | US
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Telephone | 512-890-2109
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Fax |
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Provider Business Mailing Address
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Address Line | 12775 MESA VERDE DR
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City | AUSTIN
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State | TX
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Zip | 78737-4779
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Country | US
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Telephone | 818-693-1321
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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 | 106916
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License Number State | TX
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