MEDICARE: DR. SONIA DIMAS PHD, LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	19843	TX

General Provider Information

NPI Number	:	1841343423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONIA DIMAS PHD, LPC, NCC

Provider Business Mailing Address
First Line	:	PO BOX 5323
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-0323
Country	:	US
Telephone Number	:	214-403-0265
Fax Number	:

Provider Business Practice Location Address
First Line	:	2507 NW 36TH ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78228-3918
Country	:	US
Telephone Number	:	214-403-0265
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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