Provider Demographics
NPI:1154859361
Name:FRENCH, SUSAN J (OTR)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:FRENCH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 SARGENT RD
Mailing Address - Street 2:
Mailing Address - City:GILMANTON
Mailing Address - State:NH
Mailing Address - Zip Code:03237-4235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:161 SARGENT RD
Practice Address - Street 2:
Practice Address - City:GILMANTON
Practice Address - State:NH
Practice Address - Zip Code:03237-4235
Practice Address - Country:US
Practice Address - Phone:603-998-3235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225X00000X
NH0877225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
994099OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY (NBCOT)
NH0877OtherSTATE OF NH OFFICE OF ALLIED HEALTH PROFESSIONALS