Basic Information
| Provider Information | |||||||||
| NPI: | 1346466877 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MIDDLETON | ||||||||
| FirstName: | SONJA | ||||||||
| MiddleName: | LYNN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ROBBINS | ||||||||
| OtherFirstName: | SONJA | ||||||||
| OtherMiddleName: | LYNN | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LCSW | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 10025 W MARKHAM ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722051407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016635473 | ||||||||
| FaxNumber: | 5018011816 | ||||||||
| Practice Location | |||||||||
| Address1: | 10025 WEST MARKHAM ST | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016635473 | ||||||||
| FaxNumber: | 5018011816 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2007 | ||||||||
| LastUpdateDate: | 08/12/2013 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 1788-C | AR | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.