Provider Demographics
NPI:1679144455
Name:SALTER, ETTA JAMES
Entity type:Individual
Prefix:MRS
First Name:ETTA
Middle Name:JAMES
Last Name:SALTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6182 OLD STONE CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-0001
Mailing Address - Country:US
Mailing Address - Phone:513-484-7670
Mailing Address - Fax:
Practice Address - Street 1:6182 OLD STONE CT
Practice Address - Street 2:
Practice Address - City:FAIRFIELD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45011-0001
Practice Address - Country:US
Practice Address - Phone:513-484-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2021-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker