Provider Demographics
NPI:1700196052
Name:OLIVERI, SUZANNE B (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:B
Last Name:OLIVERI
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 1:11 TIMBER CREST DR
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-2704
Mailing Address - Country:US
Mailing Address - Phone:203-826-7483
Mailing Address - Fax:
Practice Address - Street 1:11 TIMBER CREST DR
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-2704
Practice Address - Country:US
Practice Address - Phone:203-826-7483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
015960-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics