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General NPI Number Information
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NPI Number | 1083812622
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Entity Type | Individual
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Provider Name | SONIA LOUSIA QATSHA PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 11/13/2012
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Provider Practice Location Address
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Address Line | 30055 NORTHWESTERN HWY SUITE #250
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3230
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Country | US
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Telephone | 248-985-5000
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Fax | 248-985-5500
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Provider Business Mailing Address
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Address Line | 29728 ENGLISH WAY
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City | NOVI
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State | MI
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Zip | 48377-2033
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Country | US
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Telephone | 248-884-5617
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Fax | 248-788-8227
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601005013
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License Number State | MI
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