Provider Demographics
NPI:1457632093
Name:CHILDS, SONYA BENITA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:BENITA
Last Name:CHILDS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 TUITION DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7337
Mailing Address - Country:US
Mailing Address - Phone:757-237-9292
Mailing Address - Fax:
Practice Address - Street 1:5501 WESLEYAN DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-6920
Practice Address - Country:US
Practice Address - Phone:757-557-0205
Practice Address - Fax:757-557-0305
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202204551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist