Individual
SUSAN RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3226 WILKINS RD, ITHACA, NY 14850-9568
(607) 272-5891
(607) 272-0188
Mailing address
3226 WILKINS RD, ITHACA, NY 14850-9568
(607) 272-5891
(607) 272-0188
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
003419
CT
225XP0200X
Pediatric Occupational Therapist
Primary
015772
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015772
OT LICENSE
NY
Enumeration date
04/15/2008
Last updated
12/15/2011
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