Provider Demographics
NPI:1558843532
Name:POPE, SUZANNE (COTA)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:POPE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:ITALY
Mailing Address - State:TX
Mailing Address - Zip Code:76651-3510
Mailing Address - Country:US
Mailing Address - Phone:214-228-4360
Mailing Address - Fax:
Practice Address - Street 1:406 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:TX
Practice Address - Zip Code:75494-3226
Practice Address - Country:US
Practice Address - Phone:214-228-4360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty