Provider Demographics
NPI:1518185784
Name:KAHLIL, SUSAN ANNETTE (LPTA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ANNETTE
Last Name:KAHLIL
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:ANNETTE
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPTA
Mailing Address - Street 1:922 ARGYLE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1414
Mailing Address - Country:US
Mailing Address - Phone:410-669-0027
Mailing Address - Fax:
Practice Address - Street 1:2327 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-5128
Practice Address - Country:US
Practice Address - Phone:410-889-8500
Practice Address - Fax:410-889-7726
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1107225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant