Provider Demographics
NPI:1366166670
Name:SOULFIRE, VONYEE (MD)
Entity type:Individual
Prefix:MRS
First Name:VONYEE
Middle Name:
Last Name:SOULFIRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 N EL MIRAGE DR APT 224
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-3845
Mailing Address - Country:US
Mailing Address - Phone:678-620-9128
Mailing Address - Fax:
Practice Address - Street 1:3800 N EL MIRAGE DR APT 224
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-3845
Practice Address - Country:US
Practice Address - Phone:678-620-9128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-7298T101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional