Provider Demographics
NPI:1154029395
Name:SALAZAR, WENDY A
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:A
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1936 E TREMONT AVE APT MF
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-5631
Mailing Address - Country:US
Mailing Address - Phone:917-299-6720
Mailing Address - Fax:
Practice Address - Street 1:1936 E TREMONT AVE APT MF
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5631
Practice Address - Country:US
Practice Address - Phone:917-299-6720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100858104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker