Provider Demographics
NPI:1700891116
Name:ATKINSON, SONIA Z
Entity Type:Individual
Prefix:
First Name:SONIA
Middle Name:Z
Last Name:ATKINSON
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 1:8411 RIVERBIRCH DR
Mailing Address - Street 2:103
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-5987
Mailing Address - Country:US
Mailing Address - Phone:704-241-5186
Mailing Address - Fax:704-969-0817
Practice Address - Street 1:8411 RIVERBIRCH DR
Practice Address - Street 2:SUITE 103
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-5987
Practice Address - Country:US
Practice Address - Phone:704-241-5186
Practice Address - Fax:704-969-0817
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4551225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7301748Medicaid