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NPI 1588464036

NPI 1588464036 : SOPHIA ELIZABETH KELSEY : NEW ORLEANS, LA

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General NPI Number Information
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    NPI Number           |    1588464036
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    Entity Type          |    Individual 
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    Provider Name        |    SOPHIA ELIZABETH KELSEY
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/14/2025
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    Last Update Date     |    03/14/2025
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Provider Practice Location Address
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    Address Line         |    1319 JEFFERSON HWY 
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    City                 |    NEW ORLEANS
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    State                |    LA
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    Zip                  |    70121-2406
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    Country              |    US
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    Telephone            |    504-842-3900
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1832 VALENCE ST 
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    City                 |    NEW ORLEANS
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    State                |    LA
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    Zip                  |    70115-5554
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    Country              |    US
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    Telephone            |    206-512-6400
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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        |    170300000X
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    Taxonomy Name        |    Genetic Counselor (M.S.)
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    License Number       |    345814
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    License Number State |    LA
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