Healthcare Provider Details

I. General information

NPI: 1174587489
Provider Name (Legal Business Name): SONJA VICTORIA BATTEN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N GREENE ST VAMHCS (116B)
BALTIMORE MD
21201-1524
US

IV. Provider business mailing address

10 N GREENE ST VAMHCS (116B)
BALTIMORE MD
21201-1524
US

V. Phone/Fax

Practice location:
  • Phone: 410-605-7422
  • Fax: 410-605-7771
Mailing address:
  • Phone: 410-605-7422
  • Fax: 410-605-7771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number002421
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: