Provider Demographics
NPI:1275082604
Name:HUNTER, SONYA
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:HUNTER
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 1:1717 GERVAIS ST
Mailing Address - Street 2:SUITE102
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3415
Mailing Address - Country:US
Mailing Address - Phone:803-828-4020
Mailing Address - Fax:803-828-4020
Practice Address - Street 1:1717 GERVAIS ST
Practice Address - Street 2:SUITE102
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3415
Practice Address - Country:US
Practice Address - Phone:803-828-4020
Practice Address - Fax:803-828-4020
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1275082604OtherNPI
SCEX1548Medicaid
SCEX 1511OtherSC PROVIDER ID