Individual
SONIA BASTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23101 STADIUM DR, SAINT CLAIR SHORES, MI 48080-3208
(586) 435-1600
Mailing address
5128 CRESTMONT DR, TROY, MI 48098-5309
(248) 703-2236
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101005029
MI
Other
Enumeration date
06/10/2018
Last updated
06/10/2018
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