Healthcare Provider Details

I. General information

NPI: 1639211618
Provider Name (Legal Business Name): ALLISON SOLOMON PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1399 E MIA LN
GILBERT AZ
85298-6834
US

IV. Provider business mailing address

1399 E MIA LN
GILBERT AZ
85298-6834
US

V. Phone/Fax

Practice location:
  • Phone: 631-403-0863
  • Fax: 480-269-9104
Mailing address:
  • Phone: 323-356-1966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number022536
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number3968
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number3968
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number022536
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number022536
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number3968
License Number StateAZ
# 7
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3968
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: