MEDICARE: MRS. SUSAN JOY FRENCH OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	31000299A	IN

General Provider Information

NPI Number	:	1407997851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN JOY FRENCH OTR

Provider Business Mailing Address
First Line	:	342 EMS W 17 LANE
Second Line	:
City	:	NORTH WEBSTER
State	:	IN
Zip	:	46555-9509
Country	:	US
Telephone Number	:	260-438-5218
Fax Number	:	574-834-2924

Provider Business Practice Location Address
First Line	:	342 EMS W 17 LANE
Second Line	:
City	:	NORTH WEBSTER
State	:	IN
Zip	:	46555-9509
Country	:	US
Telephone Number	:	260-438-5218
Fax Number	:	574-834-2924

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/08/2007

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