Wilson, Susan Elaine

Wilson, Susan Elaine is an individual health care provider with primary practice located at 1 Oceans West Blvd , Daytona Beach Shores FL 32118-5946. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist is her primary health care specialty. Wilson, Susan Elaine can be contacted via phone (386) 252-7837.

Contact Information

Primary practice address
1 Oceans West Blvd Daytona Beach Shores FL 32118-5946
Phone: (386) 252-7837
Fax: (386) 252-0021
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT1289 Florida

Profile Details

NPI number 1811027535
LBN Legal business name Wilson, Susan Elaine
Credentials OCCUPATIONAL THERAPI
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Feb 10th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811027535 NPPES
Florida Other Z8875 BCBS
Florida MEDICAID 880176200 BCBS
Florida MEDICAID 0717141600 BCBS

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