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General NPI Number Information
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NPI Number | 1336563972
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Entity Type | Individual
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Provider Name | SUSAN COLBORN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 4324 HAUGHN ROAD SOUTH WESTERN EDUCATION PRESCHOOL CENTER - TUESDAY & WE
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City | GROVE CITY
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State | OH
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Zip | 43123
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Country | US
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Telephone | 614-801-8448
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Fax |
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Provider Business Mailing Address
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Address Line | 3805 MARLANE DRIVE SOUTH WESTERN CITY SCHOOLS
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City | GROVE CITY
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State | OH
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Zip | 43123
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Country | US
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Telephone | 614-801-3000
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Fax | 614-871-2781
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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 | OT.002139
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License Number State | OH
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