Provider Demographics
NPI:1982256319
Name:SOUSA, DANIELLE ANN
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ANN
Last Name:SOUSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 CHIEF JUSTICE CUSHING HWY
Mailing Address - Street 2:
Mailing Address - City:COHASSET
Mailing Address - State:MA
Mailing Address - Zip Code:02025-2140
Mailing Address - Country:US
Mailing Address - Phone:781-383-8001
Mailing Address - Fax:781-383-8009
Practice Address - Street 1:790 CHIEF JUSTICE CUSHING HWY
Practice Address - Street 2:
Practice Address - City:COHASSET
Practice Address - State:MA
Practice Address - Zip Code:02025-2140
Practice Address - Country:US
Practice Address - Phone:781-383-8001
Practice Address - Fax:781-383-8009
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant