Provider Demographics
NPI:1255102570
Name:EFFERTH, SUSAN (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:
Last Name:EFFERTH
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 ELMWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2464
Mailing Address - Country:US
Mailing Address - Phone:716-664-0794
Mailing Address - Fax:
Practice Address - Street 1:1905 SPRING RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-4460
Practice Address - Country:US
Practice Address - Phone:216-838-3150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics