Healthcare Provider Details

I. General information

NPI: 1700891116
Provider Name (Legal Business Name): SONIA Z. ATKINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8411 RIVERBIRCH DR SUITE 103
CHARLOTTE NC
28210-5987
US

IV. Provider business mailing address

8411 RIVERBIRCH DR 103
CHARLOTTE NC
28210-5987
US

V. Phone/Fax

Practice location:
  • Phone: 704-241-5186
  • Fax: 704-969-0817
Mailing address:
  • Phone: 704-241-5186
  • Fax: 704-969-0817

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number4551
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: