Provider Demographics
NPI:1760935894
Name:SONYA LOTT PH.D.
Entity Type:Organization
Organization Name:SONYA LOTT PH.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:LALISSE
Authorized Official - Last Name:LOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:267-825-0467
Mailing Address - Street 1:7715 CRITTENDEN ST # 330
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-4421
Mailing Address - Country:US
Mailing Address - Phone:267-825-0467
Mailing Address - Fax:
Practice Address - Street 1:607 E SEDGWICK ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1329
Practice Address - Country:US
Practice Address - Phone:267-825-0467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS006143L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty