Individual
SOPHIA DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 E MARKET ST STE A, LOUISVILLE, KY 40202-1218
(502) 588-4340
Mailing address
4822 WOODHILL LN APT 303, LOUISVILLE, KY 40219-8318
(859) 619-2871
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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