Individual
SOPHIA LADOUCEUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1600 STEWART AVE STE 300, WESTBURY, NY 11590
(516) 546-4209
Mailing address
1600 STEWART AVE STE 300, WESTBURY, NY 11590-6611
(516) 546-4209
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
6616661
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F4018011
NY
Other
Enumeration date
06/03/2014
Last updated
07/17/2018
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