Provider Demographics
NPI:1679017743
Name:SOLMAN, AVA MAI (OTR/L)
Entity Type:Individual
Prefix:
First Name:AVA
Middle Name:MAI
Last Name:SOLMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 N ACADEMY BLVD
Mailing Address - Street 2:#227
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-5337
Mailing Address - Country:US
Mailing Address - Phone:719-425-7771
Mailing Address - Fax:719-960-2248
Practice Address - Street 1:2790 N ACADEMY BLVD
Practice Address - Street 2:#227
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-5337
Practice Address - Country:US
Practice Address - Phone:719-425-7771
Practice Address - Fax:719-960-2248
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COOT.0003388OtherLICENSE