Healthcare Provider Details

I. General information

NPI: 1427019595
Provider Name (Legal Business Name): SUZANNE WINDUS M.S., O.T., C.H.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 12/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 PARK TER 2ND FLOOR
LOS ANGELES CA
90045-1543
US

IV. Provider business mailing address

5025 MAPLEWOOD AVE UNIT 16
LOS ANGELES CA
90004-2533
US

V. Phone/Fax

Practice location:
  • Phone: 310-665-7100
  • Fax:
Mailing address:
  • Phone: 215-287-0639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number46TR00311200
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOC005360L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOT 11876
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: