Provider Demographics
NPI:1518708379
Name:MASSA, SOFIE MARGARET (DPT)
Entity type:Individual
Prefix:
First Name:SOFIE
Middle Name:MARGARET
Last Name:MASSA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 SUSQUEHANNA AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-4314
Mailing Address - Country:US
Mailing Address - Phone:443-841-0837
Mailing Address - Fax:
Practice Address - Street 1:10803 FALLS RD STE 2100
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4562
Practice Address - Country:US
Practice Address - Phone:443-997-5476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29953225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist