Provider Demographics
NPI:1548957335
Name:SPOON, SONJA G
Entity type:Individual
Prefix:MRS
First Name:SONJA
Middle Name:G
Last Name:SPOON
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 1:1925 FENNER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-8711
Mailing Address - Country:US
Mailing Address - Phone:937-559-2266
Mailing Address - Fax:
Practice Address - Street 1:1925 FENNER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-8711
Practice Address - Country:US
Practice Address - Phone:937-559-2266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide