Individual
MS. SUSAN L TEUBNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2703 BROKEN ARROW, FORT WAYNE, IN 46825
(352) 978-6772
Mailing address
2703 BROKEN ARROW DR, FORT WAYNE, IN 46825-3909
(352) 978-6772
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002099A
IN
Other
Enumeration date
12/28/2011
Last updated
12/28/2011
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