Provider Demographics
NPI:1003296138
Name:SOBO, SANJA (MC, LPC)
Entity Type:Individual
Prefix:
First Name:SANJA
Middle Name:
Last Name:SOBO
Suffix:
Gender:F
Credentials:MC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8170 N 86TH PL STE 206
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4616
Mailing Address - Country:US
Mailing Address - Phone:424-272-6528
Mailing Address - Fax:
Practice Address - Street 1:8170 N 86TH PL STE 206
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4616
Practice Address - Country:US
Practice Address - Phone:424-272-6528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 15617101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional