Provider Demographics
NPI:1992932677
Name:FORD, SUE E (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SUE
Middle Name:E
Last Name:FORD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 HORTON HILL RD
Mailing Address - Street 2:UNIT 6D
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-4861
Mailing Address - Country:US
Mailing Address - Phone:203-233-1936
Mailing Address - Fax:
Practice Address - Street 1:39 HORTON HILL RD
Practice Address - Street 2:UNIT 6D
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4861
Practice Address - Country:US
Practice Address - Phone:203-723-1320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002367225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist