Provider Demographics
NPI:1154118354
Name:SALAZAR, ERIN (RD, LD)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 580
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:IN
Mailing Address - Zip Code:47941-0580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4794 LANGHORN TRL
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909-9402
Practice Address - Country:US
Practice Address - Phone:765-409-2575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL164010853133V00000X
FLND13126133V00000X
IN37003293A133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered