Provider Demographics
NPI:1336230531
Name:SOUSOULAS, MARGARET B (CNS)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:B
Last Name:SOUSOULAS
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 BELHAVEN ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38117-2320
Mailing Address - Country:US
Mailing Address - Phone:901-682-6569
Mailing Address - Fax:
Practice Address - Street 1:186 BELHAVEN ST
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-2320
Practice Address - Country:US
Practice Address - Phone:901-682-6569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20455163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult