Provider Demographics
NPI:1639646441
Name:SOLTYSIAK, PAUL
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:SOLTYSIAK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 NH ROUTE 12A
Mailing Address - Street 2:
Mailing Address - City:LANGDON
Mailing Address - State:NH
Mailing Address - Zip Code:03602-8263
Mailing Address - Country:US
Mailing Address - Phone:603-835-6318
Mailing Address - Fax:
Practice Address - Street 1:122 NH ROUTE 12A
Practice Address - Street 2:
Practice Address - City:LANGDON
Practice Address - State:NH
Practice Address - Zip Code:03602-8263
Practice Address - Country:US
Practice Address - Phone:603-835-6318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health