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General NPI Number Information
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NPI Number | 1750888244
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Entity Type | Individual
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Provider Name | SONJA STANG LSW
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Gender | Female
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 04/10/2018
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Provider Practice Location Address
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Address Line | 3306 PLAZA DR
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City | NEW ALBANY
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State | IN
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Zip | 47150-6954
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Country | US
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Telephone | 812-725-1089
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Fax |
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Provider Business Mailing Address
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Address Line | 2927 GRINSTEAD DR APT 1
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City | LOUISVILLE
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State | KY
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Zip | 40206-2644
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Country | US
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Telephone | 609-915-6955
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SL06225900
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License Number State | NJ
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