Provider Demographics
NPI:1174353304
Name:SASSONE, KARLI NICOLE (DPT)
Entity type:Individual
Prefix:
First Name:KARLI
Middle Name:NICOLE
Last Name:SASSONE
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 1:38363 SWEET MAGNOLIA DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-4258
Mailing Address - Country:US
Mailing Address - Phone:225-803-7871
Mailing Address - Fax:
Practice Address - Street 1:5258 DIJON DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4311
Practice Address - Country:US
Practice Address - Phone:225-256-3828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA11818225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist