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General NPI Number Information
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NPI Number | 1134546724
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Entity Type | Organization
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Legal Business Name | SOUL SOLUTIONS, PLLC
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Dates
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Enumeration Date | 03/21/2014
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Last Update Date | 03/21/2014
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Provider Practice Location Address
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Address Line | 107 W MAIN
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City | TRINITY
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State | TX
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Zip | 75862-0000
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Country | US
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Telephone | 409-283-1974
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Fax | 936-228-7994
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Provider Business Mailing Address
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Address Line | 6858 KINGSTON COVE LN
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City | WILLIS
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State | TX
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Zip | 77318-9121
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Country | US
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Telephone | 409-283-1974
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Fax | 936-228-7994
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON L WILLIAMS
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Credential | M.ED., LPC, NCC
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Telephone | 409-283-1974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 66084
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License Number State | TX
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