Provider Demographics
NPI:1992343156
Name:PSILLOS, ALLYSON (OTR/L)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:PSILLOS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 S AMERICAN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-6040
Mailing Address - Country:US
Mailing Address - Phone:610-564-2870
Mailing Address - Fax:
Practice Address - Street 1:1313 S AMERICAN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-6040
Practice Address - Country:US
Practice Address - Phone:610-564-2870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist