Healthcare Provider Details

I. General information

NPI: 1245713700
Provider Name (Legal Business Name): SOPHIA KOH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4516 LOWELL BLVD
DENVER CO
80211-1365
US

IV. Provider business mailing address

4516 LOWELL BLVD
DENVER CO
80211-1365
US

V. Phone/Fax

Practice location:
  • Phone: 720-515-2065
  • Fax:
Mailing address:
  • Phone: 720-515-2065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09927621
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: