Provider Demographics
NPI:1346783263
Name:TUNSTALL, SONYA MICHELLE
Entity type:Individual
Prefix:MS
First Name:SONYA
Middle Name:MICHELLE
Last Name:TUNSTALL
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 1:9013 WINCHESTER RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-7473
Mailing Address - Country:US
Mailing Address - Phone:347-844-1457
Mailing Address - Fax:
Practice Address - Street 1:9013 WINCHESTER RIDGE ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89139-7473
Practice Address - Country:US
Practice Address - Phone:347-844-1457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-25
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor