Individual
MARY JANE SONNTAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD PSYCHOLOGIST
Contact information
Practice address
1116 S WALTON BLVD, BENTONVILLE, AR 72712-6122
(479) 270-3302
(479) 845-3946
Mailing address
1116 S WALTON BLVD, BENTONVILLE, AR 72712-6122
(479) 270-3302
(479) 845-3946
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
892P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5S979
BCBS
AR
Enumeration date
05/01/2007
Last updated
07/08/2015
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