Provider Demographics
NPI:1124144175
Name:CONRAD, SUSAN ANNE (OT)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANNE
Last Name:CONRAD
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:ANNE
Other - Last Name:VARNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5056 SHARON HILL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-3431
Mailing Address - Country:US
Mailing Address - Phone:614-778-0646
Mailing Address - Fax:
Practice Address - Street 1:9403 KENWOOD RD
Practice Address - Street 2:SUITE A120
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-6895
Practice Address - Country:US
Practice Address - Phone:513-791-5766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5210225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist