Provider Demographics
NPI:1649096223
Name:ADDO, SOPHIA MILDRED
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:MILDRED
Last Name:ADDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SOPHIA
Other - Middle Name:MILDRED
Other - Last Name:VANDERPUIJE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5164 WILLNET DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45238-4345
Mailing Address - Country:US
Mailing Address - Phone:513-885-7448
Mailing Address - Fax:
Practice Address - Street 1:5164 WILLNET DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45238-4345
Practice Address - Country:US
Practice Address - Phone:513-885-7448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant