Provider Demographics
NPI:1295880888
Name:WIECEK, SONIA (MASS THER REG NURSE)
Entity type:Individual
Prefix:MS
First Name:SONIA
Middle Name:
Last Name:WIECEK
Suffix:
Gender:F
Credentials:MASS THER REG NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 LEYDEN STREET
Mailing Address - Street 2:SUITE 117
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220
Mailing Address - Country:US
Mailing Address - Phone:303-320-7609
Mailing Address - Fax:
Practice Address - Street 1:1330 LEYDEN STREET
Practice Address - Street 2:SUITE 117
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80220
Practice Address - Country:US
Practice Address - Phone:303-320-7609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO169921744G0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744G0900XOther Service ProvidersSpecialistGraphics Designer