Individual
HEIDI SOUZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
96 FOREST ST, PEABODY, MA 01960-3907
(978) 532-0303
Mailing address
2 DUCK POND RD APT 110, BEVERLY, MA 01915-7106
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18266
MA
225100000X
Physical Therapist
PT01969
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18266
PROFESSIONAL LICENSURE PHYSICAL THERAPIST
MA
Enumeration date
07/09/2009
Last updated
07/09/2009
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