Provider Demographics
NPI:1174008171
Name:PATEL, SONAL BHARAT
Entity Type:Individual
Prefix:
First Name:SONAL
Middle Name:BHARAT
Last Name:PATEL
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 1:7829 E ROCKHILL ST STE 305
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3914
Mailing Address - Country:US
Mailing Address - Phone:316-869-2888
Mailing Address - Fax:
Practice Address - Street 1:7829 E ROCKHILL ST STE 305
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3914
Practice Address - Country:US
Practice Address - Phone:316-869-2888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional