MEDICARE: SOLANGE-LOUISE PANELL BA, CADC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	07945-C	NV

General Provider Information

NPI Number	:	1063386902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOLANGE-LOUISE PANELL BA, CADC

Provider Business Mailing Address
First Line	:	2975 PANOCHA ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-2160
Country	:	US
Telephone Number	:	702-858-7691
Fax Number	:

Provider Business Practice Location Address
First Line	:	3470 W CHEYENNE AVE STE 400
Second Line	:
City	:	N LAS VEGAS
State	:	NV
Zip	:	89032-8244
Country	:	US
Telephone Number	:	702-656-0085
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	10/02/2025

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