Provider Demographics
NPI:1043623366
Name:BRUMFIELD, SUZANNE C (OTR/L, CLT)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:C
Last Name:BRUMFIELD
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N PALOMA
Mailing Address - Street 2:
Mailing Address - City:SHOW LOW
Mailing Address - State:AZ
Mailing Address - Zip Code:85901-3600
Mailing Address - Country:US
Mailing Address - Phone:740-645-2435
Mailing Address - Fax:928-367-5778
Practice Address - Street 1:300 N PALOMA
Practice Address - Street 2:
Practice Address - City:SHOW LOW
Practice Address - State:AZ
Practice Address - Zip Code:85901-3600
Practice Address - Country:US
Practice Address - Phone:740-645-2435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-04
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-005547225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist