Provider Demographics
NPI:1114416575
Name:SONJA THAYER PLLC
Entity Type:Organization
Organization Name:SONJA THAYER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:THAYER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:313-516-5194
Mailing Address - Street 1:14993 24 MILE RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-2107
Mailing Address - Country:US
Mailing Address - Phone:313-516-5194
Mailing Address - Fax:
Practice Address - Street 1:44444 HAYES RD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-7600
Practice Address - Country:US
Practice Address - Phone:313-516-5194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-01
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013086101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty