Provider Demographics
NPI:1457064743
Name:BISKUPSKI, SONYA (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:
Last Name:BISKUPSKI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2133
Mailing Address - Country:US
Mailing Address - Phone:269-519-3762
Mailing Address - Fax:
Practice Address - Street 1:2828 CONCORD ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-4618
Practice Address - Country:US
Practice Address - Phone:231-346-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101005106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist