Provider Demographics
NPI:1104695212
Name:SALAZAR, LINDA (LAC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07031-5845
Mailing Address - Country:US
Mailing Address - Phone:201-705-4979
Mailing Address - Fax:
Practice Address - Street 1:179 CAHILL CROSS RD STE 210
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1988
Practice Address - Country:US
Practice Address - Phone:973-846-1340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00767500106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist