Provider Demographics
NPI:1396432365
Name:MARENAH, SONNA
Entity type:Individual
Prefix:
First Name:SONNA
Middle Name:
Last Name:MARENAH
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 1:3230 C ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3964
Mailing Address - Country:US
Mailing Address - Phone:905-885-6537
Mailing Address - Fax:907-865-9124
Practice Address - Street 1:3230 C ST STE 100
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3964
Practice Address - Country:US
Practice Address - Phone:907-885-6537
Practice Address - Fax:907-865-9124
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4935101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)