Provider Demographics
NPI:1174072128
Name:FLOYD, SONYA TELETHA (MED, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:TELETHA
Last Name:FLOYD
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:MS
Other - First Name:SONYA
Other - Middle Name:TELETHA
Other - Last Name:DODSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MED, CCC-SLP
Mailing Address - Street 1:101 ANGELINA GRACE DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-3186
Mailing Address - Country:US
Mailing Address - Phone:478-951-5768
Mailing Address - Fax:
Practice Address - Street 1:101 ANGELINA GRACE DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-3186
Practice Address - Country:US
Practice Address - Phone:478-951-5768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-30
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist