Provider Demographics
NPI:1235438516
Name:SOLITRO, ANTHONY J II (MAC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:J
Last Name:SOLITRO
Suffix:II
Gender:M
Credentials:MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2840 SHADOW WOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-9788
Mailing Address - Country:US
Mailing Address - Phone:248-310-4817
Mailing Address - Fax:
Practice Address - Street 1:2840 SHADOW WOOD DR
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-9788
Practice Address - Country:US
Practice Address - Phone:248-310-4817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL1894203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health