Provider Demographics
NPI:1588313530
Name:SOLEDADE, MELANIE BONNER
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:BONNER
Last Name:SOLEDADE
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 1:5667 S REDWOOD RD UNIT 6
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5433
Mailing Address - Country:US
Mailing Address - Phone:385-425-3196
Mailing Address - Fax:
Practice Address - Street 1:ARBOR COUNSELING
Practice Address - Street 2:5667 S REDWOOD RD UNIT 6
Practice Address - City:TAYLORSVILLE
Practice Address - State:UT
Practice Address - Zip Code:84123-5433
Practice Address - Country:US
Practice Address - Phone:801-864-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT346253-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health