Provider Demographics
NPI:1881257046
Name:ALLEN, SONJA (HAIR LOSS SPECIALIST)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:HAIR LOSS SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 DAVID COX RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-2281
Mailing Address - Country:US
Mailing Address - Phone:704-599-2995
Mailing Address - Fax:
Practice Address - Street 1:3509 DAVID COX RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-2281
Practice Address - Country:US
Practice Address - Phone:704-599-2995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist