Basic Information
| Provider Information | |||||||||
| NPI: | 1508592817 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SONDERMANN | ||||||||
| FirstName: | MARGORIE | ||||||||
| MiddleName: | JOY | ||||||||
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| Credential: | LLPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2176 LEIGH CT | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494248721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6162187863 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3124 N WELLNESS DR STE 50 | ||||||||
| Address2: | |||||||||
| City: | HOLLAND | ||||||||
| State: | MI | ||||||||
| PostalCode: | 494248121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6168053660 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2022 | ||||||||
| LastUpdateDate: | 07/28/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 6451022309 | MI | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.