Provider Demographics
NPI:1659719219
Name:HUFF, SUSAN BROCK (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BROCK
Last Name:HUFF
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 1:2946 SHAW ST
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-1940
Mailing Address - Country:US
Mailing Address - Phone:336-626-0513
Mailing Address - Fax:
Practice Address - Street 1:2946 SHAW ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27205-1940
Practice Address - Country:US
Practice Address - Phone:336-626-0513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0898225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist