Provider Demographics
NPI:1386418366
Name:KOKIAS, EMILY ANNE (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:KOKIAS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W HORTTER ST APT 218
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2732
Mailing Address - Country:US
Mailing Address - Phone:856-217-2016
Mailing Address - Fax:
Practice Address - Street 1:601 N ITHAN AVE
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-1797
Practice Address - Country:US
Practice Address - Phone:610-526-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018166225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty