Healthcare Provider Details

I. General information

NPI: 1841215050
Provider Name (Legal Business Name): CYNTHIA H SOLOMON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CINDY H SOLOMON MS

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 WAKARA WAY
SALT LAKE CITY UT
84108-1214
US

IV. Provider business mailing address

9653 S 2720 E
SANDY UT
84092-3415
US

V. Phone/Fax

Practice location:
  • Phone: 801-883-3359
  • Fax:
Mailing address:
  • Phone: 801-883-3359
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number5080316-3601
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: