Provider Demographics
NPI:1114195542
Name:STOKER, SUSAN SKYLARRROSEHEART (BS OTR/L)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:SKYLARRROSEHEART
Last Name:STOKER
Suffix:
Gender:
Credentials:BS OTR/L
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:CAROL
Other - Last Name:STOKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS OTR/L
Mailing Address - Street 1:2330 OUTING CLUB RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6968
Mailing Address - Country:US
Mailing Address - Phone:334-559-9918
Mailing Address - Fax:
Practice Address - Street 1:1784 ELKAHATCHEE RD
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-4800
Practice Address - Country:US
Practice Address - Phone:256-329-0868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5899225X00000X
FL12311225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist