Provider Demographics
NPI:1578810990
Name:COHEN, SUSAN BLAIRE (OTR/L, EDD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BLAIRE
Last Name:COHEN
Suffix:
Gender:F
Credentials:OTR/L, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2427
Mailing Address - Country:US
Mailing Address - Phone:610-667-1105
Mailing Address - Fax:
Practice Address - Street 1:127 WOODSIDE AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2427
Practice Address - Country:US
Practice Address - Phone:610-724-7624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003940L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist