Individual
MRS. AMANDA LAUREN SUSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4102
(715) 847-2826
Mailing address
333 PINE RIDGE BLVD, WAUSAU, WI 54401-4102
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6895-26
WI
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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