Provider Demographics
NPI:1598070195
Name:DLOUGHY, SUSAN J
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:DLOUGHY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 11TH ST
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:PA
Mailing Address - Zip Code:15027-1638
Mailing Address - Country:US
Mailing Address - Phone:412-526-0424
Mailing Address - Fax:
Practice Address - Street 1:358 11TH ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:PA
Practice Address - Zip Code:15027-1638
Practice Address - Country:US
Practice Address - Phone:412-526-0424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP001778L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant