Provider Demographics
NPI:1851503148
Name:SOLOMON, EILEEN JO (PHD)
Entity Type:Individual
Prefix:DR
First Name:EILEEN
Middle Name:JO
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 SISSON ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3155
Mailing Address - Country:US
Mailing Address - Phone:301-681-2779
Mailing Address - Fax:
Practice Address - Street 1:608 SISSON ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-3155
Practice Address - Country:US
Practice Address - Phone:301-681-2779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1420103T00000X
DC1090103T00000X
PAPS004626L103T00000X
VA0810000941103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical