Individual provider · Type 1 NPI
Sophia Lasie Gough
Nursing Home Administrator · Baltimore, MD
NPI number
1295509867
Active
Practice location
1259 Limit Ave
Baltimore, MD 21239-1748
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nursing Home Administrator Primary | 376G00000X | None listed |
Nursing Home Administrator: An individual, often licensed by the state, who is responsible for the management of a nursing home.
About NPI 1295509867
Sophia Lasie Gough's National Provider Identifier is 1295509867, issued on Nov 14, 2023. The primary taxonomy on file is Nursing Home Administrator (376G00000X), and the practice location is in Baltimore, MD. The record was last updated on Nov 14, 2023.