Individual
GRACIE SOGOCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 E 17TH ST, BLOOMINGTON, IN 47408-1578
(196) 681-2855
Mailing address
10122 LANDIS BLVD, FISHERS, IN 46040-5500
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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