Provider Demographics
NPI:1770978397
Name:SONS, CRICKET MELODY (LMT)
Entity type:Individual
Prefix:
First Name:CRICKET
Middle Name:MELODY
Last Name:SONS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4546 BELLA DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-7200
Mailing Address - Country:US
Mailing Address - Phone:719-650-4002
Mailing Address - Fax:719-265-1752
Practice Address - Street 1:4546 BELLA DR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-7200
Practice Address - Country:US
Practice Address - Phone:719-650-4002
Practice Address - Fax:719-265-1752
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT 0014066171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor