Provider Demographics
NPI:1730302639
Name:SOLLANO, MIL EUGENE (FP)
Entity Type:Individual
Prefix:
First Name:MIL EUGENE
Middle Name:
Last Name:SOLLANO
Suffix:
Gender:M
Credentials:FP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5745 W COMET AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-1309
Mailing Address - Country:US
Mailing Address - Phone:623-842-5714
Mailing Address - Fax:
Practice Address - Street 1:5745 W COMET AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-1309
Practice Address - Country:US
Practice Address - Phone:623-842-5714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker