Provider Demographics
NPI:1760202287
Name:WAYNE, SUSAN LEVY
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:LEVY
Last Name:WAYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17441 HAWKSVIEW LN
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-2113
Mailing Address - Country:US
Mailing Address - Phone:216-702-4519
Mailing Address - Fax:
Practice Address - Street 1:505 S CHILLICOTHE RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-6537
Practice Address - Country:US
Practice Address - Phone:330-562-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist