Individual
SOPHIA DAE CERAVALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 UNIONVILLE INDIAN TRAIL RD W STE 100, INDIAN TRAIL, NC 28079-5665
(704) 438-9901
Mailing address
8512 CASTLEBAY DR, CHARLOTTE, NC 28277-1877
(704) 993-7155
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
9053
SC
101Y00000X
Counselor
Primary
A20522
NC
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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