Healthcare Provider Details

I. General information

NPI: 1235268699
Provider Name (Legal Business Name): SUSAN EMILY BUCK O.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2007
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3805 COLE MILL RD
DURHAM NC
27712-2903
US

IV. Provider business mailing address

3805 COLE MILL RD
DURHAM NC
27712-2903
US

V. Phone/Fax

Practice location:
  • Phone: 919-618-7795
  • Fax:
Mailing address:
  • Phone: 919-618-7795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number899
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: