Provider Demographics
NPI:1568609816
Name:JUREK, SONIA (MA LMFT)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:JUREK
Suffix:
Gender:F
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18001 N 79TH AVE
Mailing Address - Street 2:SUITE B-45
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-8388
Mailing Address - Country:US
Mailing Address - Phone:623-414-9299
Mailing Address - Fax:623-334-6724
Practice Address - Street 1:18001 N 79TH AVE
Practice Address - Street 2:SUITE B-45
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8388
Practice Address - Country:US
Practice Address - Phone:623-414-9299
Practice Address - Fax:623-334-6724
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT - 10279106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist