Provider Demographics
NPI:1598170565
Name:DOS SANTOS, SONIA (PSYD, MS)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:DOS SANTOS
Suffix:
Gender:F
Credentials:PSYD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3504 SHATTUCK AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-5038
Mailing Address - Country:US
Mailing Address - Phone:614-340-1562
Mailing Address - Fax:
Practice Address - Street 1:1990 HARMON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3829
Practice Address - Country:US
Practice Address - Phone:614-445-5960
Practice Address - Fax:614-445-7053
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5455103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical