Provider Demographics
NPI:1942601992
Name:VON SONN, MAREE THERESE
Entity Type:Individual
Prefix:MS
First Name:MAREE
Middle Name:THERESE
Last Name:VON SONN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MAREE
Other - Middle Name:THERESE
Other - Last Name:BEDDIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:74 WAIPAHE ST
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8082
Mailing Address - Country:US
Mailing Address - Phone:808-875-0155
Mailing Address - Fax:808-875-0155
Practice Address - Street 1:74 WAIPAHE ST
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8082
Practice Address - Country:US
Practice Address - Phone:808-875-0155
Practice Address - Fax:808-875-0155
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1403171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor