Healthcare Provider Details

I. General information

NPI: 1740190875
Provider Name (Legal Business Name): SOPHIA METZLER LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6137 E GRANT RD STE C
TUCSON AZ
85712-5829
US

IV. Provider business mailing address

6137 E GRANT RD STE C
TUCSON AZ
85712-5829
US

V. Phone/Fax

Practice location:
  • Phone: 520-329-1807
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLAC-88539T
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: