Provider Demographics
NPI:1588082903
Name:SALTZ, JOAN (STUDENT HID)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:
Last Name:SALTZ
Suffix:
Gender:F
Credentials:STUDENT HID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 E 10TH ST STE 5
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-7285
Mailing Address - Country:US
Mailing Address - Phone:812-288-8280
Mailing Address - Fax:812-288-8286
Practice Address - Street 1:3310 E 10TH ST STE 5
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-7285
Practice Address - Country:US
Practice Address - Phone:812-288-8280
Practice Address - Fax:812-288-8286
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN40002603A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist