Provider Demographics
NPI:1801038211
Name:KNOPF, SUSAN GREENWOOD (OTA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:GREENWOOD
Last Name:KNOPF
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2066 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6902
Mailing Address - Country:US
Mailing Address - Phone:910-231-2242
Mailing Address - Fax:910-452-4906
Practice Address - Street 1:121 RACINE DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-8705
Practice Address - Country:US
Practice Address - Phone:910-332-2723
Practice Address - Fax:910-452-4906
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5473224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant