Individual
MIRIAM SALAMANCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 E BRANCH ST, NIPOMO, CA 93444-5005
(805) 720-4483
Mailing address
PO BOX 1626, SAN LUIS OBISPO, CA 93406-1626
(805) 720-4483
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
31479
CA
Other
Enumeration date
06/02/2015
Last updated
06/02/2015
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