Provider Demographics
NPI:1376117531
Name:SOLHEID, KAYLYNN K
Entity Type:Individual
Prefix:
First Name:KAYLYNN
Middle Name:K
Last Name:SOLHEID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 N 34TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-4476
Mailing Address - Country:US
Mailing Address - Phone:715-392-8216
Mailing Address - Fax:715-392-6055
Practice Address - Street 1:1500 N 34TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-4476
Practice Address - Country:US
Practice Address - Phone:715-392-8216
Practice Address - Fax:715-392-6055
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician