Provider Demographics
NPI:1568799864
Name:SUGGS, FRITZIE
Entity Type:Individual
Prefix:
First Name:FRITZIE
Middle Name:
Last Name:SUGGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FRITZIE
Other - Middle Name:LAJA
Other - Last Name:QUIMBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:507 NORTHRIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:AR
Mailing Address - Zip Code:72956
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2233 ALMA HWY
Practice Address - Street 2:SUITE C
Practice Address - City:VAN BUREN
Practice Address - State:AR
Practice Address - Zip Code:72956
Practice Address - Country:US
Practice Address - Phone:479-474-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR1805225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist