Healthcare Provider Details

I. General information

NPI: 1013837368
Provider Name (Legal Business Name): HEIDI MARIE SONNET
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1378 BRISLIN RD
STROUDSBURG PA
18360-7684
US

IV. Provider business mailing address

1378 BRISLIN RD
STROUDSBURG PA
18360-7684
US

V. Phone/Fax

Practice location:
  • Phone: 570-236-5456
  • Fax:
Mailing address:
  • Phone: 570-236-5456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: