Individual
SUSAN KAY TAECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1502 JO LN, YANKTON, SD 57078
(605) 881-4750
Mailing address
15289 461ST AVE, SOUTH SHORE, SD 57263-5707
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0631
SD
225X00000X
Occupational Therapist
1092
NE
225X00000X
Occupational Therapist
2655
WA
225X00000X
Occupational Therapist
2823
CO
Other
Enumeration date
12/02/2012
Last updated
06/19/2018
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