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General NPI Number Information
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NPI Number | 1023658002
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Entity Type | Individual
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Provider Name | SOPHIA DUCHARME
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Gender | Female
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 2100 KRAMER LN STE 150
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City | AUSTIN
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State | TX
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Zip | 78758-4096
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Country | US
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Telephone | 737-381-1990
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Fax |
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Provider Business Mailing Address
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Address Line | 137 W 10TH ST
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City | POWELL
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State | WY
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Zip | 82435-1644
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Country | US
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Telephone | 507-429-0838
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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