Provider Demographics
NPI:1740622950
Name:GOYCO, SONJA LEE
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:LEE
Last Name:GOYCO
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 1:4600 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-9624
Mailing Address - Country:US
Mailing Address - Phone:321-258-2656
Mailing Address - Fax:
Practice Address - Street 1:801 DOUGLAS AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-5206
Practice Address - Country:US
Practice Address - Phone:407-792-5487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health