Provider Demographics
NPI:1740027655
Name:COOKMAN, SONJA MAILE (MSCP)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:MAILE
Last Name:COOKMAN
Suffix:
Gender:F
Credentials:MSCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:386 PORTLOCK RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96825-2027
Mailing Address - Country:US
Mailing Address - Phone:808-561-9047
Mailing Address - Fax:
Practice Address - Street 1:850 W HIND DR STE 210
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-1845
Practice Address - Country:US
Practice Address - Phone:808-941-9648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMFT-915106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist