Provider Demographics
NPI:1205845047
Name:SONSTENG, DIANNE LOUISE (LMT)
Entity type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:LOUISE
Last Name:SONSTENG
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 NE 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-7731
Mailing Address - Country:US
Mailing Address - Phone:352-401-9159
Mailing Address - Fax:
Practice Address - Street 1:1409 NE 22ND AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-7731
Practice Address - Country:US
Practice Address - Phone:352-401-9159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 36494174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist