Provider Demographics
NPI:1649019449
Name:STRAWN, SOPHIE ANNE (OTR/L)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:ANNE
Last Name:STRAWN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103 ROYAL BIRKDALE DR APT 16-0103
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-6963
Mailing Address - Country:US
Mailing Address - Phone:423-306-1599
Mailing Address - Fax:
Practice Address - Street 1:8514 SIX FORKS RD STE 102
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3254
Practice Address - Country:US
Practice Address - Phone:919-465-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16748225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist