Provider Demographics
NPI:1508607045
Name:SMITH, SOPHIA CATHERINE
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:CATHERINE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22101 TIMBER RIDGE DR APT SUITE
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-1873
Mailing Address - Country:US
Mailing Address - Phone:281-995-8265
Mailing Address - Fax:
Practice Address - Street 1:2121 MIDWAY RD STE 145
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-5263
Practice Address - Country:US
Practice Address - Phone:281-995-8265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant