Healthcare Provider Details

I. General information

NPI: 1548750235
Provider Name (Legal Business Name): SONYA ANNE BHATIA PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 SOUTH 70TH STREET SUITE 120
LINCOLN NE
68516
US

IV. Provider business mailing address

4501 SOUTH 70TH STREET SUITE 120
LINCOLN NE
68516
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-1936
  • Fax: 402-483-7314
Mailing address:
  • Phone: 402-483-1936
  • Fax: 402-483-7314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1037
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number10733
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: