Doctor Name: | SONIA DETTMANN |
NPI Number: | 1043398084 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 1025812 |
Business Practice Address: | 3 Dundee Park Dr General Psych Assoc Ste 203 Andover, MA - 018103723 |
Business Phone Number: | 9784753590 |
Business Fax Number: | 9784757620 |
Mailing Address: | 106 Berkshire St, CAMBRIDGE |
State: | MA |
Postal Code: | 021411417 |
Phone Number: | 6174926497 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1025812 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |