Healthcare Provider Details

I. General information

NPI: 1801220306
Provider Name (Legal Business Name): DEANNA LYNNE CUENY P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2636 S MILFORD RD
HIGHLAND MI
48357-4938
US

IV. Provider business mailing address

2677 SOUTH BLVD W
TROY MI
48098-1920
US

V. Phone/Fax

Practice location:
  • Phone: 248-765-9007
  • Fax:
Mailing address:
  • Phone: 248-765-9007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501004515
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number5501004515
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: