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General NPI Number Information
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NPI Number | 1457457277
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Entity Type | Individual
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Provider Name | SONJA M DEWEY MS, LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4343 OLD GRAND AVE # 205
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City | GURNEE
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State | IL
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Zip | 60031-2767
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Country | US
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Telephone | 224-656-7486
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Fax |
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Provider Business Mailing Address
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Address Line | 20542 W GRASS LAKE RD
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City | LAKE VILLA
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State | IL
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Zip | 60046-9210
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Country | US
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Telephone | 224-656-7486
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Fax |
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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 | 166-000663
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License Number State | IL
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