Provider Demographics
NPI:1437970944
Name:WARDEN, SOPHIE CATHERINE (OTD)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:CATHERINE
Last Name:WARDEN
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SW 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33486-4441
Mailing Address - Country:US
Mailing Address - Phone:561-866-1069
Mailing Address - Fax:
Practice Address - Street 1:1840 N DIXIE HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-1845
Practice Address - Country:US
Practice Address - Phone:561-961-4726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT20543225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist