Provider Demographics
NPI:1548051485
Name:SOLIDAGO THERAPY
Entity type:Organization
Organization Name:SOLIDAGO THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:BULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-238-7906
Mailing Address - Street 1:4000 E BRISTOL ST STE 3-313
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-6949
Mailing Address - Country:US
Mailing Address - Phone:260-502-6227
Mailing Address - Fax:
Practice Address - Street 1:4000 E BRISTOL ST STE 3-313
Practice Address - Street 2:
Practice Address - City:ELKHART
Practice Address - State:IN
Practice Address - Zip Code:46514-6949
Practice Address - Country:US
Practice Address - Phone:260-502-6227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty