Provider Demographics
NPI:1295836450
Name:BUTCHER, SOPHIE MARY (L AC)
Entity Type:Individual
Prefix:MS
First Name:SOPHIE
Middle Name:MARY
Last Name:BUTCHER
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12366 SISAR RD
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-9331
Mailing Address - Country:US
Mailing Address - Phone:805-889-4489
Mailing Address - Fax:805-933-0322
Practice Address - Street 1:308 N MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2746
Practice Address - Country:US
Practice Address - Phone:805-889-4489
Practice Address - Fax:805-933-0322
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7942171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist