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General NPI Number Information
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NPI Number | 1255931051
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Entity Type | Organization
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Legal Business Name | MIND BODY & SOL COUNSELING AND CONSULTATION
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 831 N TATNALL ST STE M
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City | WILMINGTON
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State | DE
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Zip | 19801-1717
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Country | US
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Telephone | 717-666-5062
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Fax |
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Provider Business Mailing Address
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Address Line | 18 DANBURY DR
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City | NEWARK
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State | DE
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Zip | 19702-4238
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Country | US
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Telephone | 717-666-5062
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | SOL EVANS
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Credential | MS
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Telephone | 717-666-5062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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