Provider Demographics
NPI:1619651486
Name:MCGRANN, SUZETTE KUO (OTR)
Entity Type:Individual
Prefix:
First Name:SUZETTE
Middle Name:KUO
Last Name:MCGRANN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N EVERGREEN ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1225
Mailing Address - Country:US
Mailing Address - Phone:703-627-9311
Mailing Address - Fax:
Practice Address - Street 1:205 N EVERGREEN ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1225
Practice Address - Country:US
Practice Address - Phone:703-627-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist