Provider Demographics
NPI:1275302341
Name:KNOX, SOPHIE ELOISE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:ELOISE
Last Name:KNOX
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:SOPHIE
Other - Middle Name:E
Other - Last Name:KNOX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:760 SAXONY RD UNIT A
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2350
Mailing Address - Country:US
Mailing Address - Phone:207-522-2213
Mailing Address - Fax:
Practice Address - Street 1:9520 PADGETT ST STE 104
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-4446
Practice Address - Country:US
Practice Address - Phone:885-866-8133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist