Provider Demographics
NPI:1003164955
Name:SONNE, STARR MARIE (MED; LPC)
Entity Type:Individual
Prefix:
First Name:STARR
Middle Name:MARIE
Last Name:SONNE
Suffix:
Gender:F
Credentials:MED; LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1503
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:WY
Mailing Address - Zip Code:83001-1503
Mailing Address - Country:US
Mailing Address - Phone:307-200-6388
Mailing Address - Fax:
Practice Address - Street 1:145 E SNOW KING AVE
Practice Address - Street 2:OFFICE #3
Practice Address - City:JACKSON
Practice Address - State:WY
Practice Address - Zip Code:83001-8494
Practice Address - Country:US
Practice Address - Phone:307-699-1329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2013-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLPC-779101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional