Provider Demographics
NPI:1114294386
Name:MARGE-BARROWS, SONJA JEAN (DA)
Entity Type:Individual
Prefix:
First Name:SONJA
Middle Name:JEAN
Last Name:MARGE-BARROWS
Suffix:
Gender:F
Credentials:DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 IMPERIAL PL
Mailing Address - Street 2:202D
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4638
Mailing Address - Country:US
Mailing Address - Phone:401-932-7088
Mailing Address - Fax:
Practice Address - Street 1:14 IMPERIAL PL
Practice Address - Street 2:202D
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4638
Practice Address - Country:US
Practice Address - Phone:401-932-7088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-16
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDA00387171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist