Provider Demographics
NPI:1205437167
Name:ASOUFY THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:ASOUFY THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:WIDAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ASOUFY
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:734-239-5791
Mailing Address - Street 1:916 SAINT ANDREWS REACH APT A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-8587
Mailing Address - Country:US
Mailing Address - Phone:734-239-5791
Mailing Address - Fax:
Practice Address - Street 1:916 SAINT ANDREWS REACH APT A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-8587
Practice Address - Country:US
Practice Address - Phone:734-239-5791
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service