Provider Demographics
NPI:1386221646
Name:CONRAD, SOPHIE ELIZABETH (MA)
Entity type:Individual
Prefix:MRS
First Name:SOPHIE
Middle Name:ELIZABETH
Last Name:CONRAD
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:SOPHIE
Other - Middle Name:ELIZABETH
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32971 ANNABEL AVE
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:OK
Mailing Address - Zip Code:74940
Mailing Address - Country:US
Mailing Address - Phone:760-213-9110
Mailing Address - Fax:
Practice Address - Street 1:101 PARK AVE STE 1300
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-7216
Practice Address - Country:US
Practice Address - Phone:908-900-4440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN103K00000X
TX103K00000X
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst