Individual
SUSAN PATRICIA CARMONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4710 OLD TROY PIKE, DAYTON, OH 45424-5740
(937) 855-7821
(937) 855-6972
Mailing address
4710 OLD TROY PIKE, DAYTON, OH 45424-5740
(937) 855-7821
(937) 855-6972
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
004531-1
NY
225X00000X
Occupational Therapist
Primary
OT6693
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00355344
—
NY
05
—
0510772
—
OH
01
—
11225448
CAQH
NY
Enumeration date
07/05/2006
Last updated
06/27/2008
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