Healthcare Provider Details

I. General information

NPI: 1942353503
Provider Name (Legal Business Name): SAUNDRA KAYE GUMFORY OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10587 DOUBLE R BLVD SUITE 101
RENO NV
89521-8909
US

IV. Provider business mailing address

10587 DOUBLE R BLVD SUITE 101
RENO NV
89521-8909
US

V. Phone/Fax

Practice location:
  • Phone: 775-324-5371
  • Fax: 775-852-5373
Mailing address:
  • Phone: 775-324-5371
  • Fax: 775-852-5373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0042
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: