Provider Demographics
NPI:1902491004
Name:KLYBER, SUZANNA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SUZANNA
Middle Name:
Last Name:KLYBER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SUE ANN CT
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-1923
Mailing Address - Country:US
Mailing Address - Phone:703-973-0287
Mailing Address - Fax:
Practice Address - Street 1:116 SUE ANN CT
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-1923
Practice Address - Country:US
Practice Address - Phone:703-973-0287
Practice Address - Fax:571-520-9472
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119000504225XE0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification