Provider Demographics
NPI:1083636922
Name:UFANO, SONIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:UFANO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:GOMEZ-UFANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:1018 BEACON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-4058
Mailing Address - Country:US
Mailing Address - Phone:617-277-3370
Mailing Address - Fax:617-277-4515
Practice Address - Street 1:1018 BEACON ST STE 300
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4058
Practice Address - Country:US
Practice Address - Phone:617-277-3370
Practice Address - Fax:617-277-4515
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8016103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical