Most Relevant Information
Provider Data
| NPI Number: | 1003057969 |
| Provider Name: | SONJA JO BOHANNON-THACKER MSW, LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | C003989 |
Most Important Dates
| Enumeration Date: | 03/23/2009 |
| Last Updated: | 04/11/2022 |
Provider Practice Location
363 CHURCH ST N STE 250V
CONCORD
NC
280254525
Practice Location Phone/Fax
| Phone: | 7049201199 |
| Fax: | 7049344270 |
Provider Mailing Location
300 MOORESVILLE ROAD
KANNAPOLIS
NC
280810304
Provider Mailing Phone/Fax
| Phone: | 7049201000 |
| Fax: | 7049201002 |