Provider Demographics
NPI:1043460322
Name:CUENI-SMITH, COLLEEN ANNETTE (PT)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:ANNETTE
Last Name:CUENI-SMITH
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 BOBCAT LANE
Mailing Address - Street 2:
Mailing Address - City:FOUR SEASONS
Mailing Address - State:MO
Mailing Address - Zip Code:65049-4855
Mailing Address - Country:US
Mailing Address - Phone:573-365-2057
Mailing Address - Fax:
Practice Address - Street 1:1870 BAGNELL DAM BLVD
Practice Address - Street 2:
Practice Address - City:LAKE OZARK
Practice Address - State:MO
Practice Address - Zip Code:65049-8658
Practice Address - Country:US
Practice Address - Phone:573-964-6010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO111231225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist