Provider Demographics
NPI:1386945301
Name:SALINAS, SELINA
Entity type:Individual
Prefix:
First Name:SELINA
Middle Name:
Last Name:SALINAS
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 1:4350 SIGMA RD
Mailing Address - Street 2:100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-4421
Mailing Address - Country:US
Mailing Address - Phone:972-991-6777
Mailing Address - Fax:972-991-6361
Practice Address - Street 1:4350 SIGMA RD
Practice Address - Street 2:100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75244-4421
Practice Address - Country:US
Practice Address - Phone:972-991-6777
Practice Address - Fax:972-991-6361
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10-4024171M00000X, 222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator