Provider Demographics
NPI:1396302410
Name:COHICK, SUSAN (COTA)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:COHICK
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:GALLESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:THE CENTER FOR PEDIATRIC THERAPY INC
Mailing Address - Street 2:9 BRISTOL CT
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-670-8600
Mailing Address - Fax:610-670-9104
Practice Address - Street 1:THE CENTER FOR PEDIATRIC THERAPY INC
Practice Address - Street 2:9 BRISTOL CT
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-670-8600
Practice Address - Fax:610-670-9104
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP009573224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant