Provider Demographics
NPI:1487109922
Name:SOLOMON, TORREY ANTONIO
Entity type:Individual
Prefix:
First Name:TORREY
Middle Name:ANTONIO
Last Name:SOLOMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 PECAN
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AR
Mailing Address - Zip Code:72342-3212
Mailing Address - Country:US
Mailing Address - Phone:870-338-8447
Mailing Address - Fax:870-338-8048
Practice Address - Street 1:406 PECAN
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:AR
Practice Address - Zip Code:72342-3212
Practice Address - Country:US
Practice Address - Phone:870-338-8447
Practice Address - Fax:870-338-8048
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health