Individual
MRS. SOFIA MARGARITA SOUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
200 S JORDAN AVE, BLOOMINGTON, IN 47405-7002
(812) 855-7348
Mailing address
3209 E 10TH ST, APT. A4, BLOOMINGTON, IN 47408-2492
(305) 733-6027
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005217A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891172000
—
FL
Enumeration date
04/02/2007
Last updated
01/21/2011
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