Provider Demographics
NPI:1588900997
Name:BOUZOUKIS, CAROL ELAINE (PHD)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ELAINE
Last Name:BOUZOUKIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4001 KENNETT PIKE
Mailing Address - Street 2:SUITE 244
Mailing Address - City:GREENVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19807-2315
Mailing Address - Country:US
Mailing Address - Phone:302-777-1110
Mailing Address - Fax:
Practice Address - Street 1:4001 KENNETT PIKE
Practice Address - Street 2:SUITE 244
Practice Address - City:GREENVILLE
Practice Address - State:DE
Practice Address - Zip Code:19807-2315
Practice Address - Country:US
Practice Address - Phone:302-777-1110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist