Healthcare Provider Details

I. General information

NPI: 1245493188
Provider Name (Legal Business Name): SUZANNE KATHRYN YOUNG OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 BENNETT AVE
GLENWOOD SPRINGS CO
81601-4222
US

IV. Provider business mailing address

2202 BENNETT AVE
GLENWOOD SPRINGS CO
81601-4222
US

V. Phone/Fax

Practice location:
  • Phone: 970-618-9254
  • Fax: 800-419-5080
Mailing address:
  • Phone: 970-618-9254
  • Fax: 800-419-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: