Provider Demographics
NPI:1871465393
Name:NIELD, SOFIA
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:NIELD
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 1:15804 SPADE RD
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-2223
Mailing Address - Country:US
Mailing Address - Phone:240-520-8577
Mailing Address - Fax:
Practice Address - Street 1:13214 FOUNTAIN HEAD PLZ
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2678
Practice Address - Country:US
Practice Address - Phone:301-766-9293
Practice Address - Fax:301-766-9295
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM06945225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist