Provider Demographics
NPI:1538309869
Name:LAPP, SUSAN T (BS)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:T
Last Name:LAPP
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11926 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:NY
Mailing Address - Zip Code:14590-1011
Mailing Address - Country:US
Mailing Address - Phone:315-594-1269
Mailing Address - Fax:
Practice Address - Street 1:11926 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:WOLCOTT
Practice Address - State:NY
Practice Address - Zip Code:14590
Practice Address - Country:US
Practice Address - Phone:315-594-1269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-26
Last Update Date:2009-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005326-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist