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Individual

MRS. SUSAN M LANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
913 SOUTHERLY RD, #433, TOWSON, MD 21204-2639
(440) 413-8351
Mailing address
913 SOUTHERLY RD, #433, TOWSON, MD 21204-2639
(440) 413-8351

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
04798
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1992072102
OH
Enumeration date
11/17/2011
Last updated
01/25/2016
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