Provider Demographics
NPI:1841737665
Name:MUHURI, SUSAN WANJIRU (MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:WANJIRU
Last Name:MUHURI
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:WANJIRU
Other - Last Name:MUHURI-MUGENDI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSOT, OTR/L
Mailing Address - Street 1:3105 QUINCE TREE WAY NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-8885
Mailing Address - Country:US
Mailing Address - Phone:404-754-6696
Mailing Address - Fax:
Practice Address - Street 1:3105 QUINCE TREE WAY NW
Practice Address - Street 2:
Practice Address - City:ACWORTH
Practice Address - State:GA
Practice Address - Zip Code:30101-8885
Practice Address - Country:US
Practice Address - Phone:404-754-6696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006643225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist