Provider Demographics
NPI:1174798623
Name:SOLOMON, NOVELLA (BS)
Entity type:Individual
Prefix:
First Name:NOVELLA
Middle Name:
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 S HARVARD AVE
Mailing Address - Street 2:100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2619
Mailing Address - Country:US
Mailing Address - Phone:918-584-7500
Mailing Address - Fax:918-585-2676
Practice Address - Street 1:4300 S HARVARD AVE
Practice Address - Street 2:100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2619
Practice Address - Country:US
Practice Address - Phone:918-584-7500
Practice Address - Fax:918-585-2676
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor