Individual
MRS. SUZANNE LORRAINE BUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
161 JUNCTION RD, MOCKSVILLE, NC 27028-5314
(336) 409-6530
Mailing address
161 JUNCTION RD, MOCKSVILLE, NC 27028-5314
(336) 409-6530
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
7208
NC
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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