Provider Demographics
NPI:1629968268
Name:SALT, MICHELLE SONIA (ATP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:SONIA
Last Name:SALT
Suffix:
Gender:F
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 PROFIT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-3919
Mailing Address - Country:US
Mailing Address - Phone:469-418-9902
Mailing Address - Fax:469-418-9902
Practice Address - Street 1:1221 PROFIT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-3919
Practice Address - Country:US
Practice Address - Phone:469-418-9902
Practice Address - Fax:469-418-9902
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other