Provider Demographics
NPI:1851673552
Name:NAQVI, SOOFIA AFZAL (MOT)
Entity Type:Individual
Prefix:
First Name:SOOFIA
Middle Name:AFZAL
Last Name:NAQVI
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6945 CLAYBORNE DR
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-6203
Mailing Address - Country:US
Mailing Address - Phone:314-825-6535
Mailing Address - Fax:
Practice Address - Street 1:6945 CLAYBORNE DR
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-6203
Practice Address - Country:US
Practice Address - Phone:314-825-6535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-19
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011024190225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist