Provider Demographics
NPI:1124375340
Name:KNAPINSKI, SOPHIA (LMP)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:KNAPINSKI
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2416 VIRGINIA BEACH BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3993
Mailing Address - Country:US
Mailing Address - Phone:203-946-5617
Mailing Address - Fax:
Practice Address - Street 1:2416 VIRGINIA BEACH BLVD STE 201
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3993
Practice Address - Country:US
Practice Address - Phone:206-946-5617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-07
Last Update Date:2023-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019015881225700000X
WAMA60282150225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty