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General NPI Number Information
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NPI Number | 1376069005
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Entity Type | Individual
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Provider Name | MELISSA LEE SOLDNER MC, LAC
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Gender | Female
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 08/15/2017
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Provider Practice Location Address
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Address Line | 690 E WARNER RD STE 115
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City | GILBERT
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State | AZ
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Zip | 85296-3056
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Country | US
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Telephone | 480-444-2434
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Fax | 480-588-8454
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Provider Business Mailing Address
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Address Line | 3153 E LINDA LN
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City | GILBERT
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State | AZ
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Zip | 85234-6376
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Country | US
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Telephone | 480-205-1404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LAC-16830
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License Number State | AZ
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