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General NPI Number Information
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NPI Number | 1285799296
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Entity Type | Individual
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Provider Name | SUSAN LENN OCCUPATIONAL THERAPI
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Gender | Female
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 05/01/2009
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Provider Practice Location Address
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Address Line | 3026 HIDDEN LAKE PT
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City | OWENSBORO
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State | KY
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Zip | 42303-4455
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Country | US
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Telephone | 270-316-1499
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Fax |
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Provider Business Mailing Address
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Address Line | 323 S CYPRESS ST
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City | BOONVILLE
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State | IN
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Zip | 47601-1739
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Country | US
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Telephone |
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Fax |
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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 | KYR2829
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License Number State | KY
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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 | 31003543A
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License Number State | IN
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