Provider Demographics
NPI:1053287581
Name:DR. STEPHANIE SOALT, ND
Entity type:Organization
Organization Name:DR. STEPHANIE SOALT, ND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOALT
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:203-710-3937
Mailing Address - Street 1:11 MASON ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1420
Mailing Address - Country:US
Mailing Address - Phone:203-710-3937
Mailing Address - Fax:203-212-8524
Practice Address - Street 1:215 CORAM AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3394
Practice Address - Country:US
Practice Address - Phone:203-710-3937
Practice Address - Fax:203-212-8524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty