Provider Demographics
NPI:1043664618
Name:SOLOMON, YVONNE
Entity type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11770 HAYNES BRIDGE RD STE 401-36
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-1966
Mailing Address - Country:US
Mailing Address - Phone:678-371-2138
Mailing Address - Fax:
Practice Address - Street 1:10 ELMWOOD PL NE
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30121-6056
Practice Address - Country:US
Practice Address - Phone:678-371-2138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACO093335174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist