=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336970110
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SOPHIA MANN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/12/2024
-----------------------------------------------------
Last Update Date | 10/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 35 SUMMER ST STE 202
-----------------------------------------------------
City | TAUNTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02780-3469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-828-1301
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 617 PLYMOUTH ST
-----------------------------------------------------
City | EAST BRIDGEWATER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02333-2055
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-241-4813
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------