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General NPI Number Information
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NPI Number | 1821759424
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Entity Type | Organization
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Legal Business Name | EDWARD SALAZAR
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Dates
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Enumeration Date | 01/05/2022
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 8555 E LOOP 1604 N
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City | CONVERSE
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State | TX
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Zip | 78109-2915
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Country | US
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Telephone | 210-323-7707
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Fax |
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Provider Business Mailing Address
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Address Line | 4729 GREEN BLUFF DR
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City | SCHERTZ
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State | TX
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Zip | 78154-3043
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Country | US
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Telephone | 210-323-7707
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Fax |
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Authorized Official
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Title or Position | COUNSELOR /OWNER
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Name | EDWARD RAY SALAZAR
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Credential | LPC-S
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Telephone | 210-323-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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