Provider Demographics
NPI:1770364424
Name:THIMSEN, SONIA
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:
Last Name:THIMSEN
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 1:9784 W ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85383-4174
Mailing Address - Country:US
Mailing Address - Phone:602-301-5103
Mailing Address - Fax:
Practice Address - Street 1:9784 W ROBIN LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-4174
Practice Address - Country:US
Practice Address - Phone:602-301-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered