Provider Demographics
NPI:1417188384
Name:SUTHERLAND, ONIKA M
Entity Type:Individual
Prefix:
First Name:ONIKA
Middle Name:M
Last Name:SUTHERLAND
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 1:4301 NW 18TH ST APT O201
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33313-7424
Mailing Address - Country:US
Mailing Address - Phone:954-497-4540
Mailing Address - Fax:
Practice Address - Street 1:4301 NW 18TH ST APT O201
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33313-7424
Practice Address - Country:US
Practice Address - Phone:954-497-4540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst