Provider Demographics
NPI:1912862483
Name:BOHANNON, SOFIA
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
Last Name:BOHANNON
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 1:345 S DEPEYSTER ST APT 306
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6325 COCHRAN RD STE 2
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-3930
Practice Address - Country:US
Practice Address - Phone:440-498-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-17
Last Update Date:2025-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist