Individual
SOFIA MANSUROVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
502 N BLAKELY ST, DUNMORE, PA 18512-1943
(570) 342-8434
Mailing address
1251 WYOMING AVE, EXETER, PA 18643-1434
(570) 342-8434
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF001210
PA
Other
Enumeration date
11/27/2020
Last updated
05/22/2023
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