MEDICARE: SOPHIE DIPILLO ADVOCACY GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1831595669
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOPHIE DIPILLO ADVOCACY GROUP, INC.

Provider Business Mailing Address
First Line	:	27 JACKSON ST APT 422
Second Line	:
City	:	LOWELL
State	:	MA
Zip	:	01852-2145
Country	:	US
Telephone Number	:	978-710-9274
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 JACKSON ST APT 422
Second Line	:
City	:	LOWELL
State	:	MA
Zip	:	01852-2145
Country	:	US
Telephone Number	:	978-710-9274
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER & EXECUTOR
Name	:	MR. YARED A. WEAVER
Credential	:	M.ED
Telephone Number	:	978-710-9274

Provider Enumeration Date	:	11/05/2014
Last Update Date	:	11/05/2014

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