Healthcare Provider Details

I. General information

NPI: 1033287750
Provider Name (Legal Business Name): SUZANNE MARY CRESSWELL PT, OT, CHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2449 COURT ST
REDDING CA
96001-2525
US

IV. Provider business mailing address

2449 COURT ST
REDDING CA
96001-2525
US

V. Phone/Fax

Practice location:
  • Phone: 530-244-7686
  • Fax:
Mailing address:
  • Phone: 530-244-7686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT13809
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT5351
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: