Provider Demographics
NPI:1487905022
Name:SALVATORE, CAROL ANN (MSCCCSLP)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:ANN
Last Name:SALVATORE
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 ROCK RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-1917
Mailing Address - Country:US
Mailing Address - Phone:201-805-5067
Mailing Address - Fax:
Practice Address - Street 1:30 ROCK RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-1917
Practice Address - Country:US
Practice Address - Phone:201-805-5067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-22
Last Update Date:2012-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJYS001489235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist