Healthcare Provider Details
I. General information
NPI: 1811122989
Provider Name (Legal Business Name): MOHAMED A SOLIMAN LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/19/2009
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7 PROSPECT ST
NASHUA NH
03060-3921
US
IV. Provider business mailing address
7 PROSPECT ST
NASHUA NH
03060-3921
US
V. Phone/Fax
- Phone: 603-889-6147
- Fax:
- Phone: 603-889-6147
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: