Provider Demographics
NPI:1134841711
Name:SONATIX WELLNESS
Entity type:Organization
Organization Name:SONATIX WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/BILLING
Authorized Official - Prefix:
Authorized Official - First Name:TENAE
Authorized Official - Middle Name:
Authorized Official - Last Name:DANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-461-5716
Mailing Address - Street 1:487 E 1000 S STE A
Mailing Address - Street 2:
Mailing Address - City:PLEASANT GROVE
Mailing Address - State:UT
Mailing Address - Zip Code:84062-3639
Mailing Address - Country:US
Mailing Address - Phone:801-893-6399
Mailing Address - Fax:801-206-4175
Practice Address - Street 1:487 E 1000 S STE A
Practice Address - Street 2:
Practice Address - City:PLEASANT GROVE
Practice Address - State:UT
Practice Address - Zip Code:84062-3639
Practice Address - Country:US
Practice Address - Phone:801-893-6399
Practice Address - Fax:801-206-4175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1649935693OtherNPI
UT1528611092OtherNPI