Sophia Bourdeau, lpn
Clinic/Center, Developmental Disabilities in Port St Lucie, FL. Individual provider (NPI-1).
NPI number1689104192
StatusActive
Last updated in NPPESJul 21, 2022
Details
- NPI
- 1689104192
- Entity type
- Individual (NPI-1)
- Name
- Ms. Sophia Bourdeau
- Credential
- lpn
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 16, 2017
- Last updated
- Jul 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD1600X | Clinic/Center, Developmental Disabilities | – | FL | Yes |
Practice location
159 Sw South Danville CirPort St Lucie, FL 34953-5929
Phone 754-234-3487
Mailing address
159 Sw South Danville CirPort St Lucie, FL 34953-5929
Phone 754-234-3487
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All 16 Developmental Disabilities Clinic/Center providers in Port St Lucie · All 3,747 providers in Port St Lucie
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