MEDICARE: BRANDY SOLOMON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	171M00000X	Case Manager/Care Coordinator
3	172A00000X	Driver
4	174200000X	Meals Provider
5	175T00000X	Peer Specialist
6	251B00000X	Case Management Agency
7	251C00000X	Developmentally Disabled Services Day Training Agency
8	251E00000X	Home Health Agency
9	251X00000X	Supports Brokerage Agency
10	311ZA0620X	Adult Care Home Facility
11	343900000X	Non-emergency Medical Transport (VAN)
12	372500000X	Chore Provider
13	372600000X	Adult Companion
14	374U00000X	Home Health Aide
15	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1477050912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDY SOLOMON

Provider Business Mailing Address
First Line	:	6416 W CAPITOL DR STE 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-2153
Country	:	US
Telephone Number	:	414-935-2689
Fax Number	:	414-935-2101

Provider Business Practice Location Address
First Line	:	6416 W CAPITOL DR STE 200
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53216-2153
Country	:	US
Telephone Number	:	414-935-2689
Fax Number	:	414-935-2101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2018
Last Update Date	:	04/11/2018

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Directions to “ BRANDY SOLOMON ” Practice Location

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