Provider Demographics
NPI:1700192093
Name:ESPARZA, SONIA LAUREN (MS CCC / SLP)
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:LAUREN
Last Name:ESPARZA
Suffix:
Gender:F
Credentials:MS CCC / SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2959 SHARPSBURG MCCULLUM RD
Mailing Address - Street 2:BUILDING C, SUITE C
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30265-2297
Mailing Address - Country:US
Mailing Address - Phone:770-683-0250
Mailing Address - Fax:770-683-4250
Practice Address - Street 1:2959 SHARPSBURG MCCULLUM RD
Practice Address - Street 2:BUILDING C, SUITE C
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30265-2297
Practice Address - Country:US
Practice Address - Phone:770-683-0250
Practice Address - Fax:770-683-4250
Is Sole Proprietor?:No
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GASLP007395235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist