Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TH0004X | Health Psychologist | 1184 | LA |
NPI | 1124044300 |
---|---|
Provider Name | Dr. Bridget L. Sonnier-Hillis |
First Address | Baton Rouge, LA 70808-8729 |
Second Address | Baton Rouge, LA 70817-5128 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 15/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P00300649 | RR MEDICARE (01) | |
P80207 | (02) | NE |