Provider Demographics
NPI:1184604134
Name:HUSSEY, YANNOULA ARISTIDIS (PT)
Entity type:Individual
Prefix:
First Name:YANNOULA
Middle Name:ARISTIDIS
Last Name:HUSSEY
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 1:2475 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HINCKLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44233-9788
Mailing Address - Country:US
Mailing Address - Phone:330-273-2885
Mailing Address - Fax:
Practice Address - Street 1:3487 CENTER RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:OH
Practice Address - Zip Code:44212-3624
Practice Address - Country:US
Practice Address - Phone:330-225-0553
Practice Address - Fax:330-220-8272
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT01833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HU0877092Medicare ID - Type Unspecified