Provider Demographics
NPI:1568196277
Name:EVANS, SONIA (SLP)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:EVANS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SONIA REIMANN
Mailing Address - Street 1:PO BOX 2129
Mailing Address - Street 2:
Mailing Address - City:GLEN ROSE
Mailing Address - State:TX
Mailing Address - Zip Code:76043
Mailing Address - Country:US
Mailing Address - Phone:254-898-3741
Mailing Address - Fax:
Practice Address - Street 1:707 SW BIG BEND TRL
Practice Address - Street 2:
Practice Address - City:GLEN ROSE
Practice Address - State:TX
Practice Address - Zip Code:76043-4423
Practice Address - Country:US
Practice Address - Phone:254-898-3471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX118711235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist