Provider Demographics
NPI:1437768942
Name:SIMS, SUSANNAH WATSON (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SUSANNAH
Middle Name:WATSON
Last Name:SIMS
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 1:32209 JASPER RD
Mailing Address - Street 2:
Mailing Address - City:DOZIER
Mailing Address - State:AL
Mailing Address - Zip Code:36028-7684
Mailing Address - Country:US
Mailing Address - Phone:334-488-7931
Mailing Address - Fax:
Practice Address - Street 1:193 SAM LISENBY RD
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-3048
Practice Address - Country:US
Practice Address - Phone:334-445-6336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4670225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics