Provider Demographics
NPI:1427781384
Name:OU, SOPHIA M (MA)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:M
Last Name:OU
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 N MICHIGAN AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3959
Mailing Address - Country:US
Mailing Address - Phone:773-358-6684
Mailing Address - Fax:872-264-4585
Practice Address - Street 1:444 N MICHIGAN AVE STE 1200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3959
Practice Address - Country:US
Practice Address - Phone:773-358-6684
Practice Address - Fax:872-264-4585
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional