Individual
JACLYN SOLOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4218-M ARENDELL ST, MOREHEAD CITY, NC 28557
(252) 808-3100
Mailing address
4218-M ARENDELL ST, MOREHEAD CITY, NC 28557
(252) 808-3100
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9132
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9132
STATE LICENSE
NC
Enumeration date
03/19/2014
Last updated
03/19/2014
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