Individual
MS. SOPHIA BOURDEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
159 SW SOUTH DANVILLE CIR, PORT ST LUCIE, FL 34953-5929
(754) 234-3487
Mailing address
159 SW SOUTH DANVILLE CIR, PORT ST LUCIE, FL 34953-5929
(754) 234-3487
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
FL
Other
Enumeration date
06/16/2017
Last updated
07/21/2022
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