MEDICARE: SOPHIE GEORGE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst	1-24-77048	MA

General Provider Information

NPI Number	:	1568163160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SOPHIE GEORGE

Provider Business Mailing Address
First Line	:	35 PHELPS AVE
Second Line	:
City	:	NORTH ADAMS
State	:	MA
Zip	:	01247-3140
Country	:	US
Telephone Number	:	413-822-7610
Fax Number	:

Provider Business Practice Location Address
First Line	:	35 PHELPS AVE
Second Line	:
City	:	NORTH ADAMS
State	:	MA
Zip	:	01247-3140
Country	:	US
Telephone Number	:	413-822-7610
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2023
Last Update Date	:	11/10/2024

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Directions to “ SOPHIE GEORGE ” Practice Location

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