Provider Demographics
NPI:1730492968
Name:SOLLENBARGER, BAHAREH S
Entity Type:Individual
Prefix:
First Name:BAHAREH
Middle Name:S
Last Name:SOLLENBARGER
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 1:3913 N VISTA DE LA CIMA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-6741
Mailing Address - Country:US
Mailing Address - Phone:520-425-9144
Mailing Address - Fax:
Practice Address - Street 1:3913 N VISTA DE LA CIMA STE A-150
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-6741
Practice Address - Country:US
Practice Address - Phone:520-425-9144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-16
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4442213103TS0200X
2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool