Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 6301003320 | MI |
Y | 103TC0700X | Clinical Psychologist | 6301003320 | MI |
NPI | 1013111665 |
---|---|
Provider Name | Dr. Mitchell Solomon |
First Address | Farmington Hills, MI 48331-5975 |
Second Address | Farmington Hills, MI 48335-2867 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 08/07/2007 |