Provider Demographics
NPI:1669775193
Name:ALONSO OBREGON, SONIA CRISTINA (MS SLP)
Entity type:Individual
Prefix:MISS
First Name:SONIA
Middle Name:CRISTINA
Last Name:ALONSO OBREGON
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WILLIAMS BLVD
Mailing Address - Street 2:APTO 1E
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2450
Mailing Address - Country:US
Mailing Address - Phone:516-304-9618
Mailing Address - Fax:
Practice Address - Street 1:6 WILLIAMS BLVD
Practice Address - Street 2:APTO 1E
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755
Practice Address - Country:US
Practice Address - Phone:516-304-9618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-05
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020637-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist