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General NPI Number Information
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NPI Number | 1366992067
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Entity Type | Organization
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Legal Business Name | SHANNON SOLIE THERAPY INCORPORTED
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 5370 WILSON AVE S
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City | SEATTLE
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State | WA
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Zip | 98118-2566
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Country | US
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Telephone | 206-456-6133
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Fax |
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Provider Business Mailing Address
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Address Line | 5370 WILSON AVE S
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City | SEATTLE
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State | WA
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Zip | 98118-2566
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Country | US
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Telephone | 206-456-6133
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | MS. SHANNON SOLIE
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Credential | LMHC
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Telephone | 206-456-6133
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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 | LH60628391
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License Number State | WA
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