Provider Demographics
NPI:1316978521
Name:ANTONIO, ANNE SOLTIS (LISW)
Entity type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:SOLTIS
Last Name:ANTONIO
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:ANTONIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW
Mailing Address - Street 1:35000 CHARDON RD STE 115
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44094-9018
Mailing Address - Country:US
Mailing Address - Phone:440-918-1806
Mailing Address - Fax:
Practice Address - Street 1:35000 CHARDON RD STE 115
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY HILLS
Practice Address - State:OH
Practice Address - Zip Code:44094-9018
Practice Address - Country:US
Practice Address - Phone:440-918-1806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00060611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW12953Medicare UPIN