Individual
KATIE D. SALAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
620 W MAIN ST, SUITE 101, LEAGUE CITY, TX 77573-3777
(281) 316-0709
(281) 316-0699
Mailing address
PO BOX 1295, LEAGUE CITY, TX 77574-1295
(281) 316-0709
(281) 316-0699
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
23875
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098882601
—
TX
05
—
098882602
—
TX
01
—
260031508
RR MEDICARE
TX
01
—
260031510
RR MEDICARE
TX
01
—
81540P
BCBS
TX
Enumeration date
06/18/2006
Last updated
07/16/2010
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