Provider Demographics
NPI:1407079387
Name:SOLOMON, JANET MARIE (MSWPSC)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:MSWPSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 WUTH RD
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-9227
Mailing Address - Country:US
Mailing Address - Phone:270-554-0237
Mailing Address - Fax:270-554-0237
Practice Address - Street 1:7310 WURTH RD
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-9227
Practice Address - Country:US
Practice Address - Phone:270-554-0237
Practice Address - Fax:270-554-0237
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3461171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00987OtherPSC #