Healthcare Provider Details

I. General information

NPI: 1093625535
Provider Name (Legal Business Name): SOPHIA NORAH LOTT MM, MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 W BETHANY HOME RD STE B
PHOENIX AZ
85019-1953
US

IV. Provider business mailing address

3660 W BETHANY HOME RD STE B
PHOENIX AZ
85019-1953
US

V. Phone/Fax

Practice location:
  • Phone: 602-626-8851
  • Fax:
Mailing address:
  • Phone: 602-626-8851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number14587
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: