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1104120922
SOPHIA ANNEZA TASOULIS
KENNETT SQUARE, PA
NPI
1104120922
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225XP0019X Occupational Therapist, Physical Rehabilitation
(Licence: MD 02830)
Enumeration Date
2011-01-09
Last Update Date
2011-01-09
Business Address
-- SOPHIA ANNEZA TASOULIS OTR/L
101 E STATE ST
KENNETT SQUARE, PA 19348-3109
Phone number: 610-444-6350
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Mailing Address
-- SOPHIA ANNEZA TASOULIS OTR/L
744 N RIVERSIDE DR
CROWNSVILLE, MD 21032-1709
Phone number: 410-923-0187
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