Provider Demographics
NPI:1467052316
Name:SONNENBERG, LEE (PHARMD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:SONNENBERG
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DUNG
Other - Middle Name:
Other - Last Name:THAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:157 GARY HATFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72740-3730
Mailing Address - Country:US
Mailing Address - Phone:479-738-1270
Mailing Address - Fax:
Practice Address - Street 1:157 GARY HATFIELD WAY
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740-3730
Practice Address - Country:US
Practice Address - Phone:479-738-1270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68775183500000X
ARPD12120183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist