Individual
MRS. SUZANNE SUTTERFIELD WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
7213 SIWELL ROAD, BYRAM, MS 39272
(601) 346-9191
(601) 346-5011
Mailing address
110 LAKE RIDGE DR, MADISON, MS 39110-8291
(601) 346-9191
(601) 346-5011
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1421
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02377597
—
MS
Enumeration date
07/18/2006
Last updated
02/13/2012
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