Provider Demographics
NPI:1891819108
Name:SOILES, KAREN TAYLOR (PT)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:TAYLOR
Last Name:SOILES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DONCASTER ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02131-4610
Mailing Address - Country:US
Mailing Address - Phone:703-477-9454
Mailing Address - Fax:617-553-4479
Practice Address - Street 1:515 PROVIDENCE HWY STE LOWER6
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-6811
Practice Address - Country:US
Practice Address - Phone:703-646-0313
Practice Address - Fax:617-553-4479
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204518225100000X
MA9007225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1891819108OtherINDIVIDUAL NPI
1538567557OtherORGANIZATIONAL NPI