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General NPI Number Information
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NPI Number | 1134841711
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Entity Type | Organization
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Legal Business Name | SONATIX WELLNESS
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Dates
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Enumeration Date | 09/12/2022
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Last Update Date | 01/19/2023
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Provider Practice Location Address
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Address Line | 487 E 1000 S STE A
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-3639
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Country | US
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Telephone | 801-893-6399
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Fax | 801-206-4175
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Provider Business Mailing Address
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Address Line | 487 E 1000 S STE A
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-3639
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Country | US
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Telephone | 801-893-6399
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Fax | 801-206-4175
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Authorized Official
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Title or Position | OFFICE MANAGER/BILLING
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Name | TENAE DANA
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Credential |
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Telephone | 208-461-5716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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