Provider Demographics
NPI:1740317080
Name:GALLIMORE, SONIA ELAINE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:SONIA
Middle Name:ELAINE
Last Name:GALLIMORE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11998 NW 13TH STREET
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026
Mailing Address - Country:US
Mailing Address - Phone:305-305-1792
Mailing Address - Fax:305-279-8080
Practice Address - Street 1:8525 SW 92 STREET
Practice Address - Street 2:A3
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33156
Practice Address - Country:US
Practice Address - Phone:305-305-1792
Practice Address - Fax:305-279-8080
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1747106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist