=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184943490
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MONICA JANE WAFSTET-SOLIN LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2010
-----------------------------------------------------
Last Update Date | 05/26/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 720 W BOONE AVE SUITE 102
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99201-2560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-328-3802
-----------------------------------------------------
Fax | 509-328-3871
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 720 W BOONE AVE SUITE 102
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99201-2560
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-328-3802
-----------------------------------------------------
Fax | 509-328-3871
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LH00005548
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------