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General NPI Number Information
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NPI Number | 1912309014
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Entity Type | Individual
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Provider Name | SHANNON SALUK
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Gender | Female
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Dates
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Enumeration Date | 09/19/2014
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Last Update Date | 07/03/2023
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Provider Practice Location Address
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Address Line | 3101 N FEDERAL HWY STE 606A
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City | FT LAUDERDALE
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State | FL
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Zip | 33306-1018
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Country | US
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Telephone | 954-873-4565
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Fax |
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Provider Business Mailing Address
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Address Line | 819 NE 26TH ST
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City | WILTON MANORS
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State | FL
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Zip | 33305-1239
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Country | US
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Telephone |
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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 |
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License Number State |
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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 | SW19724
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License Number State | FL
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