Provider Demographics
NPI:1235936949
Name:HENNINGTON, SUZANNA
Entity type:Individual
Prefix:
First Name:SUZANNA
Middle Name:
Last Name:HENNINGTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 N LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-2522
Mailing Address - Country:US
Mailing Address - Phone:985-981-8877
Mailing Address - Fax:
Practice Address - Street 1:1242 S MORRISON BLVD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5702
Practice Address - Country:US
Practice Address - Phone:985-402-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA345702225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand