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General NPI Number Information
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NPI Number | 1710456686
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Entity Type | Individual
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Provider Name | YEIRA DELEON-SOLIS LAPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 175 GWINNETT DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8444
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Country | US
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Telephone | 678-209-2394
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Fax |
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Provider Business Mailing Address
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Address Line | 1174 SANDUNE DR
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City | NORCROSS
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State | GA
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Zip | 30093-4221
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Country | US
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Telephone | 770-256-7958
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | APC006736
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License Number State | GA
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