Provider Demographics
NPI:1609406545
Name:TESTA, SUSAN LYNN (OTR/L)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:LYNN
Last Name:TESTA
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 1:1945 BRADY LAKE RD UNIT J
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3037
Mailing Address - Country:US
Mailing Address - Phone:330-606-8780
Mailing Address - Fax:
Practice Address - Street 1:3927 38TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2900
Practice Address - Country:US
Practice Address - Phone:330-493-0096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-20
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT-2310225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist