Provider Demographics
NPI:1871143800
Name:TOWNSEND, SONYA LORRAINE
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:LORRAINE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12814 HAWTHORNE SHORES DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044-1255
Mailing Address - Country:US
Mailing Address - Phone:832-602-0388
Mailing Address - Fax:
Practice Address - Street 1:12814 HAWTHORNE SHORES DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044-1255
Practice Address - Country:US
Practice Address - Phone:832-602-0388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services