Individual provider · NPI-1

Sofie Azmy, PsyD/HSPP

Psychologist, Clinical · Fort Wayne, IN

NPI number1366993750
StatusActive
Last updated in NPPESNov 7, 2022

Details

NPI
1366993750
Entity type
Individual (NPI-1)
Name
Sofie Azmy
Credential
PsyD/HSPP
Sex
Female
Sole proprietor
No
Enumeration date
Oct 20, 2016
Certification date
Nov 7, 2022
Last updated
Nov 7, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC0700X Psychologist, Clinical20042936AINYes
103TC0700X Psychologist, Clinical071010772IL

Practice location

5534 Saint Joe Rd
Fort Wayne, IN 46835-3328

Phone 219-224-8855

Mailing address

5534 Saint Joe Rd
Fort Wayne, IN 46835-3328

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