Provider Demographics
NPI:1235893777
Name:ALSPAUGH, SUSAN COLLETTE (COTA/L)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:COLLETTE
Last Name:ALSPAUGH
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6978 PHEASANT VIEW DR
Mailing Address - Street 2:
Mailing Address - City:TEMPERANCE
Mailing Address - State:MI
Mailing Address - Zip Code:48182-2324
Mailing Address - Country:US
Mailing Address - Phone:567-686-7582
Mailing Address - Fax:
Practice Address - Street 1:HICKORY RIDGE
Practice Address - Street 2:951 HICKORY CREEK BLVD
Practice Address - City:TEMPERANCE
Practice Address - State:MI
Practice Address - Zip Code:48182
Practice Address - Country:US
Practice Address - Phone:734-206-8200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5202006998224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant