MEDICARE: CYNTHIA H SOLOMON MS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)	5080316-3601	UT

General Provider Information

NPI Number	:	1841215050
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA H SOLOMON MS

Provider Business Mailing Address
First Line	:	9653 S 2720 E
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84092-3415
Country	:	US
Telephone Number	:	801-883-3359
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 WAKARA WAY
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1214
Country	:	US
Telephone Number	:	801-883-3359
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	07/08/2007

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