Provider Demographics
NPI:1649331026
Name:ROPER, SONJA JEAN (BS, CSAC, NCGC1)
Entity type:Individual
Prefix:
First Name:SONJA
Middle Name:JEAN
Last Name:ROPER
Suffix:
Gender:F
Credentials:BS, CSAC, NCGC1
Other - Prefix:
Other - First Name:SONJA
Other - Middle Name:JEAN
Other - Last Name:LAZARZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3136 CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6109
Mailing Address - Country:US
Mailing Address - Phone:715-835-9110
Mailing Address - Fax:715-830-4098
Practice Address - Street 1:3136 CRAIG RD
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6109
Practice Address - Country:US
Practice Address - Phone:715-835-9110
Practice Address - Fax:715-830-4098
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13531101YA0400X
WI15392-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)