Provider Demographics
NPI:1679066740
Name:CEURVELS, SUSAN THERESA (OTR, MS)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:THERESA
Last Name:CEURVELS
Suffix:
Gender:F
Credentials:OTR, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 WALPOLE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030-1636
Mailing Address - Country:US
Mailing Address - Phone:781-820-8473
Mailing Address - Fax:
Practice Address - Street 1:156 WALPOLE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:MA
Practice Address - Zip Code:02030-1636
Practice Address - Country:US
Practice Address - Phone:781-820-8473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-12
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3262225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist