Individual
SUSAN E BOUSQUET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3701 WAKE FOREST RD STE 100, RALEIGH, NC 27609-6832
(919) 872-3171
(919) 872-6739
Mailing address
3701 WAKE FOREST RD STE 100, RALEIGH, NC 27609-6832
(919) 872-3171
(757) 321-3332
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119007609
VA
225X00000X
Occupational Therapist
Primary
13417
NC
225XH1200X
Hand Occupational Therapist
0119007609
VA
225XH1200X
Hand Occupational Therapist
13417
NC
Other
Enumeration date
02/14/2018
Last updated
09/18/2020
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