Provider Demographics
NPI:1144985011
Name:TELLO, CYNTHIA SOLORIO (MSW)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:SOLORIO
Last Name:TELLO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24700 BOMBAY AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-1111
Mailing Address - Country:US
Mailing Address - Phone:310-339-3931
Mailing Address - Fax:
Practice Address - Street 1:8040 ORTONVILLE RD
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48348-4468
Practice Address - Country:US
Practice Address - Phone:248-989-5432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-04
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA959101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical