Provider Demographics
NPI:1407411572
Name:LEWICKI, SOPHIA ZOE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SOPHIA
Middle Name:ZOE
Last Name:LEWICKI
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 VASSAR AVE
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-1634
Mailing Address - Country:US
Mailing Address - Phone:610-328-2147
Mailing Address - Fax:
Practice Address - Street 1:64B FOREST DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1142
Practice Address - Country:US
Practice Address - Phone:484-557-3287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-04
Last Update Date:2019-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist