Provider Demographics
NPI:1275917841
Name:LEFEVRE, SOPHIE DEVORAH (CTRS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIE
Middle Name:DEVORAH
Last Name:LEFEVRE
Suffix:
Gender:F
Credentials:CTRS, BCBA
Other - Prefix:
Other - First Name:SOPHIE
Other - Middle Name:DEVORAH
Other - Last Name:LESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CTRS
Mailing Address - Street 1:3588 PLYMOUTH RD # 393
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2603
Mailing Address - Country:US
Mailing Address - Phone:734-352-3543
Mailing Address - Fax:734-547-5462
Practice Address - Street 1:7794 PAINT CREEK DR
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-6139
Practice Address - Country:US
Practice Address - Phone:734-352-3543
Practice Address - Fax:734-547-5462
Is Sole Proprietor?:No
Enumeration Date:2015-07-14
Last Update Date:2023-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1-23-65697103K00000X
MI66391225800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst