Provider Demographics
NPI:1174411920
Name:TREMBLAY, SOPHIA
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:
Last Name:TREMBLAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 NANTASKET AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-1262
Mailing Address - Country:US
Mailing Address - Phone:781-901-2397
Mailing Address - Fax:
Practice Address - Street 1:1185 NANTASKET AVE APT 6
Practice Address - Street 2:
Practice Address - City:HULL
Practice Address - State:MA
Practice Address - Zip Code:02045-1262
Practice Address - Country:US
Practice Address - Phone:781-901-2397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician