Provider Demographics
NPI:1487157301
Name:PRICE, SUSAN STOODT (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:STOODT
Last Name:PRICE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:HELEN
Other - Last Name:STOODT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:CHESTERFIELD TECHNICAL CENTER HULL
Mailing Address - Street 2:13900 HULL STREET RD.
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112
Mailing Address - Country:US
Mailing Address - Phone:804-639-8788
Mailing Address - Fax:804-639-6396
Practice Address - Street 1:CHESTERFIELD TECHNICAL CENTER HULL
Practice Address - Street 2:13900 HULL STREET RD.
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23112
Practice Address - Country:US
Practice Address - Phone:804-639-8788
Practice Address - Fax:804-639-6396
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000487225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist