Provider Demographics
NPI:1326898420
Name:GAINES, SONDRA MICHELE (EDD)
Entity Type:Individual
Prefix:DR
First Name:SONDRA
Middle Name:MICHELE
Last Name:GAINES
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 ENFIELD CHASE CT APT 215
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3278
Mailing Address - Country:US
Mailing Address - Phone:240-355-7818
Mailing Address - Fax:
Practice Address - Street 1:3800 ENFIELD CHASE CT APT 215
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3278
Practice Address - Country:US
Practice Address - Phone:240-355-7818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health