Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1041C0700X | Clinical Social Worker | 016208 | PA |
Y | 1041C0700X | Clinical Social Worker | 1469 | NH |
NPI | 1003057464 |
---|---|
Provider Name | Dina Landis Solomon |
First Address | Manchester, NH 03104-1641 |
Second Address | Bedford, NH 03110-6448 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2009 |
Last Update Date | 01/05/2009 |