Individual
ASHLEY SOUSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
4761 HIGHWAY 501, SUITE 1, MYRTLE BEACH, SC 29579-9457
(843) 455-7505
Mailing address
PO BOX 1523, LITTLE RIVER, SC 29566-1523
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4676
SC
Other
Enumeration date
02/10/2016
Last updated
02/04/2019
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