Healthcare Provider Details

I. General information

NPI: 1376719245
Provider Name (Legal Business Name): CHRISTINE SOFIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2008
Last Update Date: 05/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 TOWN CENTER PKWY SUITE 305
RESTON VA
20190-5851
US

IV. Provider business mailing address

8316 ARLINGTON BLVD SUITE 300
FAIRFAX VA
22031-5207
US

V. Phone/Fax

Practice location:
  • Phone: 703-834-2907
  • Fax:
Mailing address:
  • Phone: 703-573-7600
  • Fax: 703-573-2694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: