Provider Demographics
NPI:1063693257
Name:SEDLAK, SALVA CORINNE (LISW)
Entity type:Individual
Prefix:MRS
First Name:SALVA
Middle Name:CORINNE
Last Name:SEDLAK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-1926
Mailing Address - Country:US
Mailing Address - Phone:330-497-6129
Mailing Address - Fax:
Practice Address - Street 1:1206 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1926
Practice Address - Country:US
Practice Address - Phone:330-497-6129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI5951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical