Provider Demographics
NPI:1912524448
Name:SALERNO, DOVONYA (LMFT)
Entity type:Individual
Prefix:
First Name:DOVONYA
Middle Name:
Last Name:SALERNO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:DOVE
Other - Middle Name:
Other - Last Name:SALERNO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:429 AGAVE AZUL WAY
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-3159
Mailing Address - Country:US
Mailing Address - Phone:562-833-5153
Mailing Address - Fax:
Practice Address - Street 1:429 AGAVE AZUL WAY
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-3159
Practice Address - Country:US
Practice Address - Phone:562-833-5153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA113100106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist