Individual
SOPHONIA JEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DS
Contact information
Practice address
801 PLEASANT ST, BROCKTON, MA 02301-3052
(508) 856-5977
Mailing address
801 PLEASANT ST, BROCKTON, MA 02301-3052
(508) 856-5977
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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