Provider Demographics
NPI:1750300190
Name:GEMMELL-CROSBY, SUSAN JEAN (OTR)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:JEAN
Last Name:GEMMELL-CROSBY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:
Other - Last Name:CROSBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:821 E ASPEN AVE
Mailing Address - Street 2:
Mailing Address - City:FRUITA
Mailing Address - State:CO
Mailing Address - Zip Code:81521-2301
Mailing Address - Country:US
Mailing Address - Phone:970-858-4439
Mailing Address - Fax:
Practice Address - Street 1:821 E ASPEN AVE
Practice Address - Street 2:
Practice Address - City:FRUITA
Practice Address - State:CO
Practice Address - Zip Code:81521-2301
Practice Address - Country:US
Practice Address - Phone:970-858-4439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist