Individual
SUSAN SIFFERLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2218 DONNELLY DRIVE NW, BUFFALO, MN 55313-2739
(320) 493-6249
Mailing address
2218 DONNELLY DR NW, BUFFALO, MN 55313-2739
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
100582
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100582
MN OT LICENSE
MN
Enumeration date
08/01/2013
Last updated
08/01/2013
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