Provider Demographics
NPI:1306054333
Name:SONNENMEIER, RAE M (PHD, CCC-SKP)
Entity type:Individual
Prefix:
First Name:RAE
Middle Name:M
Last Name:SONNENMEIER
Suffix:
Gender:F
Credentials:PHD, CCC-SKP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 COLLEGE RD
Mailing Address - Street 2:PETTEE HALL 103
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-2621
Mailing Address - Country:US
Mailing Address - Phone:603-862-1860
Mailing Address - Fax:603-862-0034
Practice Address - Street 1:55 COLLEGE RD
Practice Address - Street 2:PETTEE HALL 103
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-2621
Practice Address - Country:US
Practice Address - Phone:603-862-1860
Practice Address - Fax:603-862-0034
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0482235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30400632Medicaid