Provider Demographics
NPI:1174078489
Name:SOLLER, JASMINE (AA, AASWY)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:SOLLER
Suffix:
Gender:F
Credentials:AA, AASWY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 COLLEGE CT APT A
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRINGS
Mailing Address - State:WY
Mailing Address - Zip Code:82901-4547
Mailing Address - Country:US
Mailing Address - Phone:307-679-3682
Mailing Address - Fax:
Practice Address - Street 1:101 COLLEGE CT APT A
Practice Address - Street 2:
Practice Address - City:ROCK SPRINGS
Practice Address - State:WY
Practice Address - Zip Code:82901-4547
Practice Address - Country:US
Practice Address - Phone:307-679-3682
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker