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NPI Code Detail

MEDICARE: SOFIA WOLDU

MEDICARE: SOFIA WOLDU
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1720616634
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOFIA WOLDU
Provider Business Mailing Address
First Line : 3201 ESPERANZA XING APT 125
Second Line :
City : AUSTIN
State : TX
Zip : 78758-7860
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8324 CAMERON RD
Second Line :
City : AUSTIN
State : TX
Zip : 78754-3990
Country : US
Telephone Number : 469-396-7293
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2020
Last Update Date : 03/28/2020

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Directions to “ SOFIA WOLDU ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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