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General NPI Number Information
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NPI Number | 1477475077
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Entity Type | Organization
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Legal Business Name | SOUL SUTRA LLC
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 3075 W RAY RD STE 200
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City | CHANDLER
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State | AZ
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Zip | 85226-2496
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Country | US
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Telephone | 520-449-4842
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Fax |
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Provider Business Mailing Address
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Address Line | 2115 E INDIAN WELLS DR
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City | CHANDLER
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State | AZ
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Zip | 85249-4866
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Country | US
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Telephone | 520-449-4842
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | CALISTA HEATH-MARTINEZ
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Credential | DBH, LCSW
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Telephone | 520-449-4842
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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