Provider Demographics
NPI:1235890179
Name:SOKOL, STATIA ELAINE (MT-BC)
Entity Type:Individual
Prefix:MS
First Name:STATIA
Middle Name:ELAINE
Last Name:SOKOL
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19523 OLEANDER RIDGE WAY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-2323
Mailing Address - Country:US
Mailing Address - Phone:817-736-6551
Mailing Address - Fax:
Practice Address - Street 1:19523 OLEANDER RIDGE WAY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-2323
Practice Address - Country:US
Practice Address - Phone:817-736-6551
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
17003225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist