MEDICARE: MRS. SONYA DENISE GREGG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	222Q00000X	Developmental Therapist
3	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1467600460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SONYA DENISE GREGG

Provider Business Mailing Address
First Line	:	1857 LEE ROAD 197
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36870-8219
Country	:	US
Telephone Number	:	334-520-0144
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 13TH ST
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31901-2246
Country	:	US
Telephone Number	:	706-780-1704
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	01/12/2021

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Directions to “ MRS. SONYA DENISE GREGG ” Practice Location

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