Provider Demographics
NPI:1376172148
Name:SOLIS, ABIGAIL ESPARZA
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:ESPARZA
Last Name:SOLIS
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 1:3560 LIBERATOR DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-8556
Mailing Address - Country:US
Mailing Address - Phone:915-383-2179
Mailing Address - Fax:
Practice Address - Street 1:3560 LIBERATOR DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938
Practice Address - Country:US
Practice Address - Phone:915-383-2179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
175T00000X
COLPC.0018377101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175T00000XOther Service ProvidersPeer Specialist