Provider Demographics
NPI:1679019103
Name:MCHENRY, SONIA JO
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:JO
Last Name:MCHENRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:JO
Other - Last Name:BRANDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2211 16TH ST NW STE 6
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-1215
Mailing Address - Country:US
Mailing Address - Phone:701-852-0388
Mailing Address - Fax:701-852-6785
Practice Address - Street 1:2211 16TH ST NW STE 6
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58703-1215
Practice Address - Country:US
Practice Address - Phone:701-852-0388
Practice Address - Fax:701-852-6785
Is Sole Proprietor?:No
Enumeration Date:2017-01-08
Last Update Date:2017-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDRPH5845183500000X
TX32239183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist