Provider Demographics
NPI:1316312804
Name:SOGEGIAN, DONNA
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:SOGEGIAN
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 1:5153 SALMON DR SE
Mailing Address - Street 2:APT B
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-6346
Mailing Address - Country:US
Mailing Address - Phone:727-460-5607
Mailing Address - Fax:
Practice Address - Street 1:5153 SALMON DR SE
Practice Address - Street 2:APT B
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-6346
Practice Address - Country:US
Practice Address - Phone:727-460-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-09
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW6878104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker