Provider Demographics
NPI:1922269034
Name:SUCHMA, MARY ANN (OT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ANN
Last Name:SUCHMA
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 W STRATFORD AVE
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-1802
Mailing Address - Country:US
Mailing Address - Phone:610-284-9242
Mailing Address - Fax:
Practice Address - Street 1:114 W STRATFORD AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-1802
Practice Address - Country:US
Practice Address - Phone:610-284-9242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003624L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist