Provider Demographics
NPI:1750037503
Name:THOMAS, ANZA SUSAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANZA
Middle Name:SUSAN
Last Name:THOMAS
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 1:150 N BETHLEHEM PIKE APT B109
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-4330
Mailing Address - Country:US
Mailing Address - Phone:484-885-3443
Mailing Address - Fax:
Practice Address - Street 1:150 N BETHLEHEM PIKE APT B109
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-4330
Practice Address - Country:US
Practice Address - Phone:484-885-3443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC018320225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist