Individual
DR. SCOTT W SALON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1481
Mailing address
2121 LAKE AVE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 460-1481
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20010504A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200082950
—
IN
Enumeration date
07/21/2005
Last updated
04/15/2013
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