Provider Demographics
NPI:1053518431
Name:KNOTT, SUSAN ROSE (OTRL)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:ROSE
Last Name:KNOTT
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 CURDSVILLE-DELAWARE RD
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-8950
Mailing Address - Country:US
Mailing Address - Phone:270-316-2622
Mailing Address - Fax:270-771-4212
Practice Address - Street 1:4318 CURDSVILLE DELAWARE RD
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-8950
Practice Address - Country:US
Practice Address - Phone:270-316-2622
Practice Address - Fax:270-771-4212
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-R3547225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist