Healthcare Provider Details

I. General information

NPI: 1922683747
Provider Name (Legal Business Name): HEIDI J CUETT OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 03/12/2021
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W MCLEAN ST
ALHAMBRA CA
91801-1322
US

IV. Provider business mailing address

556 S. FAIR OAKS AVE., STE. 101 #120
PASADENA CA
91105
US

V. Phone/Fax

Practice location:
  • Phone: 714-519-5158
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number22109
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: