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General NPI Number Information
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NPI Number | 1134520356
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Entity Type | Individual
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Provider Name | SUSAN JAHN
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Gender | Female
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Dates
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Enumeration Date | 09/08/2014
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Last Update Date | 09/08/2014
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Provider Practice Location Address
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Address Line | 1338A COLEGATE DR
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-373-6669
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Fax | 740-376-5809
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Provider Business Mailing Address
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Address Line | 1338A COLEGATE DR
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City | MARIETTA
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State | OH
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Zip | 45750
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Country | US
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Telephone | 740-373-6669
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Fax | 740-376-5809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OH-006709
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1288
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OH-006709
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License Number State | OH
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