Individual
SUSAN JEAN FENNESSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
12320 ESCADA DR, CHESTERFIELD, VA 23832-3800
(804) 873-1249
Mailing address
12320 ESCADA DR, CHESTERFIELD, VA 23832-3800
(804) 873-1249
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000726
VA
Other
Enumeration date
05/04/2012
Last updated
05/04/2012
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