Individual
MS. SOPHANARY LORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
1551 PACIFIC AVE, SANTA ROSA, CA 95404-3568
(512) 922-3138
Mailing address
1551 PACIFIC AVE, SANTA ROSA, CA 95404-3568
(512) 922-3138
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
ND623
CA
Other
Enumeration date
05/16/2011
Last updated
03/14/2014
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