Provider Demographics
NPI:1477716884
Name:HILL, SONJA REGINA (MT)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:REGINA
Last Name:HILL
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 PALMETTO OAKS WAY LOT 55
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:GA
Mailing Address - Zip Code:30268-1343
Mailing Address - Country:US
Mailing Address - Phone:404-734-5778
Mailing Address - Fax:
Practice Address - Street 1:120 MILLBROOK VILLAGE DR
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-3605
Practice Address - Country:US
Practice Address - Phone:470-601-7421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT001063171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor