Provider Demographics
NPI:1881839439
Name:SONI, THEJASVEE (SLP)
Entity Type:Individual
Prefix:
First Name:THEJASVEE
Middle Name:
Last Name:SONI
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:THEJASVEE
Other - Middle Name:
Other - Last Name:SINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:230 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1916
Mailing Address - Country:US
Mailing Address - Phone:860-674-1824
Mailing Address - Fax:860-674-1836
Practice Address - Street 1:230 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1916
Practice Address - Country:US
Practice Address - Phone:860-674-1824
Practice Address - Fax:860-674-1836
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003535235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist