Provider Demographics
NPI:1720316201
Name:BRITTON, SUSAN L (COTA)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:L
Last Name:BRITTON
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 COCHRAN DR
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-2367
Mailing Address - Country:US
Mailing Address - Phone:219-628-2031
Mailing Address - Fax:
Practice Address - Street 1:431 COCHRAN DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-2367
Practice Address - Country:US
Practice Address - Phone:219-628-2031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-22
Last Update Date:2009-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2890224Z00000X
FL11039224Z00000X
IN32000513A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant