Provider Demographics
NPI:1114441045
Name:GUTHRIE, SONYA KAY
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:KAY
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 KAUFMAN DR
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-2179
Mailing Address - Country:US
Mailing Address - Phone:304-363-4891
Mailing Address - Fax:
Practice Address - Street 1:130 KAUFMAN DR
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-2179
Practice Address - Country:US
Practice Address - Phone:304-363-4891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2363225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant