Provider Demographics
NPI:1083085179
Name:STAWICKI, SUZANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:STAWICKI
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 1:15 ORMSBEE AVE
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-1122
Mailing Address - Country:US
Mailing Address - Phone:614-537-3707
Mailing Address - Fax:
Practice Address - Street 1:15 ORMSBEE AVE
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-1122
Practice Address - Country:US
Practice Address - Phone:614-537-3707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH8975225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics