Provider Demographics
NPI:1437190592
Name:SONNENBURG, HEIDI JANE
Entity type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:JANE
Last Name:SONNENBURG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:J
Other - Last Name:SONNENBURG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:5516 GREENING LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-1220
Mailing Address - Country:US
Mailing Address - Phone:608-238-1321
Mailing Address - Fax:608-238-5870
Practice Address - Street 1:7818 BIG SKY DR
Practice Address - Street 2:SUITE 106
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-3524
Practice Address - Country:US
Practice Address - Phone:608-238-1321
Practice Address - Fax:608-238-5870
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI214-026225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist