Provider Demographics
NPI:1255486023
Name:SOLI, SYDNEY JANE (MS)
Entity Type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:JANE
Last Name:SOLI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:SYDNEY
Other - Middle Name:JANE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:16675 S 18TH WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-9450
Mailing Address - Country:US
Mailing Address - Phone:480-227-7715
Mailing Address - Fax:480-460-2834
Practice Address - Street 1:16675 S 18TH WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-9450
Practice Address - Country:US
Practice Address - Phone:480-460-2834
Practice Address - Fax:480-838-0061
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP0170235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZSLP0170OtherAZ DEPT HEALTH SERVICES