Provider Demographics
NPI:1467718056
Name:SOHL, SUSANNAH LESEURE (MOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNAH
Middle Name:LESEURE
Last Name:SOHL
Suffix:
Gender:F
Credentials:MOTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 S 24TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1149
Mailing Address - Country:US
Mailing Address - Phone:908-821-5999
Mailing Address - Fax:
Practice Address - Street 1:519 S 24TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1149
Practice Address - Country:US
Practice Address - Phone:908-821-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-08
Last Update Date:2012-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011265225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist