Individual
SUSAN RENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT/R
Contact information
Practice address
176 MAIN ST, KENNEDY DONOVAN CENTER, SOUTHBRIDGE, MA 01550-2561
(508) 765-0292
(508) 765-0294
Mailing address
176 MAIN ST, KENNEDY DONOVAN CENTER, SOUTHBRIDGE, MA 01550-2561
(508) 765-0292
(508) 765-0294
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
484
MA
Other
Enumeration date
01/02/2008
Last updated
01/02/2008
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