Provider Demographics
NPI:1790820686
Name:FIELDS, SONIA ANGELA FLAKE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SONIA
Middle Name:ANGELA FLAKE
Last Name:FIELDS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WATERFORD WAY
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-9001
Mailing Address - Country:US
Mailing Address - Phone:770-317-6708
Mailing Address - Fax:
Practice Address - Street 1:130 WATERFORD WAY
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-9001
Practice Address - Country:US
Practice Address - Phone:770-317-6708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist