Individual
SOPHONIE THEODORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2955 VINE RIDGE DR, POWDER SPRINGS, GA 30127-1785
(678) 736-1865
Mailing address
2955 VINE RIDGE DR, POWDER SPRINGS, GA 30127-1785
(678) 736-1865
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
01/21/2026
Last updated
01/21/2026
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