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General NPI Number Information
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NPI Number | 1942400270
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Entity Type | Individual
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Provider Name | DAVID C SOLLY D.ED.
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Gender | Male
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 08/16/2007
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Provider Practice Location Address
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Address Line | 1880 OFFICE CLUB PT SUITE 4300
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920-5002
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Country | US
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Telephone | 719-272-8310
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Fax | 719-282-6006
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Provider Business Mailing Address
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Address Line | 7855 PINE CONE RD SUITE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80908-6117
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Country | US
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Telephone | 719-338-4665
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Fax | 719-495-7458
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2835
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License Number State | CO
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