Healthcare Provider Details

I. General information

NPI: 1811407547
Provider Name (Legal Business Name): KETTY DE LOS ANGELES SILVA SOLIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2017
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 MAPLE ST
HOLYOKE MA
01040-5144
US

IV. Provider business mailing address

230 MAPLE ST
HOLYOKE MA
01040-5144
US

V. Phone/Fax

Practice location:
  • Phone: 413-532-0389
  • Fax:
Mailing address:
  • Phone: 413-532-0389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: