Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003323445 |
---|---|
Provider Name | Bethany Michelle Solomon |
First Address | Arlington, TX 76018-1000 |
Second Address | Arlington, TX 76018-1000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2018 |
Last Update Date | 08/01/2018 |