Provider Demographics
NPI:1356519953
Name:COX, SUSAN LYNN (OTR/L)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:LYNN
Last Name:COX
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 FLEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-2216
Mailing Address - Country:US
Mailing Address - Phone:209-577-2212
Mailing Address - Fax:
Practice Address - Street 1:301 FLEETWOOD DR
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-2216
Practice Address - Country:US
Practice Address - Phone:209-577-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7326225XE1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics