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General NPI Number Information
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NPI Number | 1588917058
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Entity Type | Individual
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Provider Name | SUE M HENRY O.T.R/L
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Gender | Female
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 02/20/2026
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Provider Practice Location Address
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Address Line | 2109 OTOOLE AVE STE M
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City | SAN JOSE
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State | CA
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Zip | 95131-1338
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Country | US
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Telephone | 408-573-7720
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Fax | 408-753-9555
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Provider Business Mailing Address
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Address Line | 2109 OTOOLE AVE STE M
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City | SAN JOSE
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State | CA
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Zip | 95131-1338
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Country | US
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Telephone | 408-573-7720
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Fax | 408-753-9555
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 1899
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License Number State | CA
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