Individual
MRS. SUSAN LYNNE BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5677 S TRANSIT RD, SUITE # 318, LOCKPORT, NY 14094-5842
(716) 625-4002
Mailing address
404 HOMESTEAD DR, NORTH TONAWANDA, NY 14120-1649
(716) 693-2408
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
001131-1
NY
Other
Enumeration date
01/31/2010
Last updated
01/31/2010
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