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General NPI Number Information
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NPI Number | 1801922976
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Entity Type | Individual
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Provider Name | SONIA JEAN MASSE MS, PA, ATC, PES
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Gender | Female
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Dates
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Enumeration Date | 02/25/2007
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 149 NORTH ST
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City | WATERVILLE
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State | ME
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Zip | 04901-4974
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Country | US
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Telephone | 207-873-8140
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Fax |
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Provider Business Mailing Address
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Address Line | 18 MILLBROOK LN
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City | AUBURN
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State | ME
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Zip | 04210-4091
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Country | US
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Telephone | 724-825-8074
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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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 | PA1363
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License Number State | ME
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