Provider Demographics
NPI:1962012716
Name:SONGER, CARLA J
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:J
Last Name:SONGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:21523-1016
Mailing Address - Country:US
Mailing Address - Phone:301-359-5143
Mailing Address - Fax:
Practice Address - Street 1:42 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MD
Practice Address - Zip Code:21523-1016
Practice Address - Country:US
Practice Address - Phone:301-359-5143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant