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General NPI Number Information
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NPI Number | 1639047525
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Entity Type | Organization
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Legal Business Name | SOLEA WELLNESS
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Dates
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Enumeration Date | 10/23/2025
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 615 EDITH DR
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City | BELEN
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State | NM
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Zip | 87002-2807
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Country | US
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Telephone | 505-588-8563
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 CORRALES RD UNIT 8
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City | CORRALES
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State | NM
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Zip | 87048-4000
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Country | US
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Telephone | 505-588-8563
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GABRIELLE ANZURES
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Credential | LPCC
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Telephone | 505-588-8563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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