Provider Demographics
NPI:1699435792
Name:SOLOMON, TOLICIA CANTRICE (LMT)
Entity type:Individual
Prefix:
First Name:TOLICIA
Middle Name:CANTRICE
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 RAMOS DR APT 44
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-4440
Mailing Address - Country:US
Mailing Address - Phone:347-963-7794
Mailing Address - Fax:
Practice Address - Street 1:1615 RAMOS DR APT 44
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-4440
Practice Address - Country:US
Practice Address - Phone:347-963-7794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT134675225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist