# DANIEL SALVATORE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265042956
- **Authorized official:** SUE ROACH (BILLING ADMINISTRATOR)
- **Authorized official phone:** (860) 368-7092

## Contact information

- **Practice address:** 12 ROOSEVELT AVE \# 36, MYSTIC, CT 06355-2809
- **Practice address phone:** (860) 912-0672
- **Mailing address:** 12 ROOSEVELT AVE \# 36, MYSTIC, CT 06355-2809
- **Mailing address phone:** (860) 912-0672

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/06/2020
- **Last updated:** 04/08/2025