Provider Demographics
NPI:1821083833
Name:HARRIS, SONIE J (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:SONIE
Middle Name:J
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:SONIE
Other - Middle Name:J
Other - Last Name:HEATHMAN-SOHRWEID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:UNC SPEECH AND AUDIOLOGY CLINIC
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80639-0001
Mailing Address - Country:US
Mailing Address - Phone:970-351-2014
Mailing Address - Fax:970-351-1601
Practice Address - Street 1:UNC SPEECH AND AUDIOLOGY CLINIC
Practice Address - Street 2:GUNTER HALL ROOM 0330
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80639-0001
Practice Address - Country:US
Practice Address - Phone:970-351-2014
Practice Address - Fax:970-351-1601
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO394231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO18254276Medicaid
539678Medicare ID - Type Unspecified