Provider Demographics
NPI:1396901484
Name:LUDWIG, SUZANNE (COTA/L)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:LUDWIG
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60211 CHERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BYESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43723-9420
Mailing Address - Country:US
Mailing Address - Phone:740-260-6794
Mailing Address - Fax:
Practice Address - Street 1:60211 CHERRY HILL RD
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723-9420
Practice Address - Country:US
Practice Address - Phone:740-260-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOTA00942224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant