Provider Demographics
NPI:1033553243
Name:HETUE, LINDA M (MSOT, MHA, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:HETUE
Suffix:
Gender:F
Credentials:MSOT, MHA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 STATE PARK RD
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:MA
Mailing Address - Zip Code:02045-3263
Mailing Address - Country:US
Mailing Address - Phone:781-925-7094
Mailing Address - Fax:
Practice Address - Street 1:9 STATE PARK RD
Practice Address - Street 2:
Practice Address - City:HULL
Practice Address - State:MA
Practice Address - Zip Code:02045-3263
Practice Address - Country:US
Practice Address - Phone:781-925-7094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6760225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist