Provider Demographics
NPI:1912174772
Name:ANTHONY, SONYA (SCAD-TRAINEE)
Entity Type:Individual
Prefix:MS
First Name:SONYA
Middle Name:
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:SCAD-TRAINEE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5980 CULLEN DR
Mailing Address - Street 2:
Mailing Address - City:SABILLASVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21780-9702
Mailing Address - Country:US
Mailing Address - Phone:240-420-5400
Mailing Address - Fax:
Practice Address - Street 1:5980 CULLEN DR
Practice Address - Street 2:
Practice Address - City:SABILLASVILLE
Practice Address - State:MD
Practice Address - Zip Code:21780-9702
Practice Address - Country:US
Practice Address - Phone:240-420-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)