Individual
GABRIEL SALAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCAS
Contact information
Practice address
209 SPARTAN RD, APT. 105, WILMINGTON, NC 28405-3917
(910) 547-7103
Mailing address
209 SPARTAN RD, WILMINGTON, NC 28405-3917
(910) 547-7103
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1625
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6112157
—
NC
Enumeration date
05/10/2010
Last updated
05/04/2011
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