Provider Demographics
NPI:1528199569
Name:BROWN, SUSAN LOUISE (MOT,OTR)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:LOUISE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MOT,OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15271 W 147TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-4796
Mailing Address - Country:US
Mailing Address - Phone:913-254-9064
Mailing Address - Fax:
Practice Address - Street 1:8614 W 138TH TER
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-1130
Practice Address - Country:US
Practice Address - Phone:816-914-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-01332225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist