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General NPI Number Information
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NPI Number | 1326202409
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Entity Type | Individual
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Provider Name | SONYA M. COSUMANO LMFT, M.ED.
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Gender | Female
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Dates
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Enumeration Date | 07/17/2008
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 435 CHAPEL RD STE E
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-4157
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Country | US
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Telephone | 860-436-4390
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Fax | 860-436-6448
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Provider Business Mailing Address
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Address Line | 435 CHAPEL RD STE E
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City | SOUTH WINDSOR
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State | CT
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Zip | 06074-4157
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Country | US
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Telephone | 860-436-4390
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Fax | 860-436-6448
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001265
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License Number State | CT
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