Individual
SOPHIA ANNEZA TASOULIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 444-6350
Mailing address
744 N RIVERSIDE DR, CROWNSVILLE, MD 21032-1709
(410) 923-0187
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
02830
MD
Other
Enumeration date
01/09/2011
Last updated
01/09/2011
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