Individual
SOPHIE GROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2520 GREEN ST, PHILOMATH, OR 97370-9201
(154) 122-1070
Mailing address
2520 GREEN ST, PHILOMATH, OR 97370-9201
(154) 122-1070
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
—
OR
374J00000X
Doula
Primary
—
—
Other
Enumeration date
02/23/2020
Last updated
02/23/2020
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