Provider Demographics
NPI:1477727576
Name:PIKE, SOPHIE (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:SOPHIE
Middle Name:
Last Name:PIKE
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 DERBY DOWNS DR
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-9398
Mailing Address - Country:US
Mailing Address - Phone:910-546-3759
Mailing Address - Fax:
Practice Address - Street 1:3303 US HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-6929
Practice Address - Country:US
Practice Address - Phone:252-675-2381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10425235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist