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General NPI Number Information
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NPI Number | 1619533106
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Entity Type | Individual
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Provider Name | BRIANNA LEE SOLOMON OTRL
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Gender | Female
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Dates
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Enumeration Date | 05/10/2019
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 275 N CALEDONIA DR
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City | OWOSSO
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State | MI
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Zip | 48867-8844
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Country | US
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Telephone | 989-743-3491
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Fax |
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Provider Business Mailing Address
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Address Line | 2397 E FREELAND RD
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City | FREELAND
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State | MI
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Zip | 48623-9449
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Country | US
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Telephone | 989-859-9713
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 5201010599
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License Number State | MI
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