Provider Demographics
NPI:1902161367
Name:SOLOT, ELLEN K (MA)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:K
Last Name:SOLOT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:191 N HIGH ST
Mailing Address - Street 2:A
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-3753
Mailing Address - Country:US
Mailing Address - Phone:707-823-9106
Mailing Address - Fax:
Practice Address - Street 1:191 N HIGH ST
Practice Address - Street 2:A
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-3753
Practice Address - Country:US
Practice Address - Phone:707-823-9106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist