Provider Demographics
NPI:1558308767
Name:DUNFORD, SUE ANN (OTR L)
Entity Type:Individual
Prefix:MS
First Name:SUE ANN
Middle Name:
Last Name:DUNFORD
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 1:118 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14616-4041
Mailing Address - Country:US
Mailing Address - Phone:585-865-4146
Mailing Address - Fax:
Practice Address - Street 1:88 KIRKLAND RD.
Practice Address - Street 2:ROCHESTER CITY SCHOOL DISTRICT
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611
Practice Address - Country:US
Practice Address - Phone:585-262-8466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0009981225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist