Provider Demographics
NPI:1790008209
Name:SOLOMON NEUROPSYCHOLOGY, LLC
Entity Type:Organization
Organization Name:SOLOMON NEUROPSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SOLOMON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:812-345-2585
Mailing Address - Street 1:3196 PARLIAMENT CIR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-7271
Mailing Address - Country:US
Mailing Address - Phone:334-272-8949
Mailing Address - Fax:
Practice Address - Street 1:3196 PARLIAMENT CIR
Practice Address - Street 2:SUITE 400
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-7271
Practice Address - Country:US
Practice Address - Phone:334-272-8949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1584103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty