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General NPI Number Information
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NPI Number | 1407921166
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Entity Type | Individual
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Provider Name | JENNIFER L. SOLLEDER LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 10025 WEST MARKHAM ST STE. 210
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-663-5473
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Fax | 501-801-1816
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Provider Business Mailing Address
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Address Line | 10025 WEST MARKHAM ST STE. 210
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City | LITTLE ROCK
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State | AR
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Zip | 72205
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Country | US
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Telephone | 501-663-5473
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Fax | 501-801-1816
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1969-M
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License Number State | AR
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