Provider Demographics
NPI:1598308710
Name:PRICE, SONYA PATRICE (NCC)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:PATRICE
Last Name:PRICE
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6600 KITTEN LAKE DR APT 1224
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31820-3786
Mailing Address - Country:US
Mailing Address - Phone:706-577-3133
Mailing Address - Fax:
Practice Address - Street 1:6600 KITTEN LAKE DR APT 1224
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:GA
Practice Address - Zip Code:31820-3786
Practice Address - Country:US
Practice Address - Phone:706-577-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA80444101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor