Provider Demographics
NPI:1194424788
Name:SOPHER, FELICIA NICOLE (LMBT, RD)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:NICOLE
Last Name:SOPHER
Suffix:
Gender:F
Credentials:LMBT, RD
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:NICOLE
Other - Last Name:LAMB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3168 ROCK POND CIR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-7956
Mailing Address - Country:US
Mailing Address - Phone:757-618-8989
Mailing Address - Fax:
Practice Address - Street 1:208 FOUST ST STE D
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-5574
Practice Address - Country:US
Practice Address - Phone:336-625-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL007302133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered