Basic Information
| Provider Information | |||||||||
| NPI: | 1154486231 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ULMER | ||||||||
| FirstName: | SUZANNE | ||||||||
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| Credential: | LOTR, CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8280 YMCA PLAZA DR | ||||||||
| Address2: | STE. 3-A | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708100927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257570164 | ||||||||
| FaxNumber: | 2257578757 | ||||||||
| Practice Location | |||||||||
| Address1: | 8280 YMCA PLAZA DR | ||||||||
| Address2: | STE. 3-A | ||||||||
| City: | BATON ROUGE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 708100927 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2257570164 | ||||||||
| FaxNumber: | 2257578757 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Z12031 | LA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.