MEDICARE: MS. SUSAN W SONNI MS

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	103TS0200X	School Psychologist	3409	PR

General Provider Information

NPI Number	:	1922756790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN W SONNI MS

Provider Business Mailing Address
First Line	:	3950 CARR 176 APT 53
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-6612
Country	:	US
Telephone Number	:	787-612-6912
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 AVE MUNOZ RIVERA STE 248
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-3346
Country	:	US
Telephone Number	:	787-612-6912
Fax Number	:

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

Provider Enumeration Date	:	03/11/2022
Last Update Date	:	03/11/2022

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