Provider Demographics
NPI:1174998587
Name:SALISBURY, HOLLY (PSYD)
Entity type:Individual
Prefix:DR
First Name:HOLLY
Middle Name:
Last Name:SALISBURY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 E HIGHLAND AVE
Mailing Address - Street 2:SUITE 170
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4835
Mailing Address - Country:US
Mailing Address - Phone:623-692-8240
Mailing Address - Fax:
Practice Address - Street 1:2211 E HIGHLAND AVE
Practice Address - Street 2:SUITE 170
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4835
Practice Address - Country:US
Practice Address - Phone:623-692-8240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-10
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4135103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic