| Doctor Name: | MRS. SUSAN JANE RICHARD |
| NPI Number: | 1093996217 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | 2156 |
| Business Practice Address: | 31 Lake St Gardner, MA - 014403879 |
| Business Phone Number: | 9786324432 |
| Business Fax Number: | |
| Mailing Address: | 31 Lake St, GARDNER |
| State: | MA |
| Postal Code: | 014403879 |
| Phone Number: | 9786324432 |
| Fax Number: | |
| NPI Enumeration Date: | 11/15/2007 |
| NPI Last Update Date: | 11/15/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | 2156 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |