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General NPI Number Information
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NPI Number | 1871355784
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Entity Type | Individual
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Provider Name | SUSAN SOLSTICE LPC
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Gender | Female
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Dates
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Enumeration Date | 01/25/2024
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Last Update Date | 01/25/2024
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Provider Practice Location Address
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Address Line | 2851 S AVENUE B BLDG 4
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City | YUMA
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State | AZ
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Zip | 85364-7726
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Country | US
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Telephone | 928-376-0026
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Fax |
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Provider Business Mailing Address
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Address Line | 13477 E 43RD DR
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City | YUMA
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State | AZ
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Zip | 85367-6239
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Country | US
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Telephone | 928-261-0603
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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 | 22578
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License Number State | AZ
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