Provider Demographics
NPI:1194328633
Name:LAMARCA, SOPHIA LILLIAN
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:LILLIAN
Last Name:LAMARCA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16056 HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-2763
Mailing Address - Country:US
Mailing Address - Phone:678-906-7575
Mailing Address - Fax:
Practice Address - Street 1:16056 HENDERSON RD
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-2763
Practice Address - Country:US
Practice Address - Phone:678-906-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program