Provider Demographics
NPI:1649468877
Name:SALAS, JOANNE (PHD)
Entity type:Individual
Prefix:DR
First Name:JOANNE
Middle Name:
Last Name:SALAS
Suffix:
Gender:F
Credentials:PHD
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 1636
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78667-1636
Mailing Address - Country:US
Mailing Address - Phone:512-665-7324
Mailing Address - Fax:
Practice Address - Street 1:829 N. LBJ DR
Practice Address - Street 2:SUITE 207
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:77667-1636
Practice Address - Country:US
Practice Address - Phone:512-665-7324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2007-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33377103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33377OtherLICENSE