Provider Demographics
NPI:1720180102
Name:WILLIAMS, SONJA COLLETTE (LIC PROF COUNSELOR)
Entity Type:Individual
Prefix:MS
First Name:SONJA
Middle Name:COLLETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LIC PROF COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270005
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127
Mailing Address - Country:US
Mailing Address - Phone:314-540-0545
Mailing Address - Fax:314-892-8765
Practice Address - Street 1:11005 ACTON DRIVE
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-7003
Practice Address - Country:US
Practice Address - Phone:314-540-0545
Practice Address - Fax:314-892-8765
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003032184101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional