Provider Demographics
NPI:1235884990
Name:HALL, SYDNEE CHEYENNE (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:SYDNEE
Middle Name:CHEYENNE
Last Name:HALL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-2117
Mailing Address - Country:US
Mailing Address - Phone:304-523-1164
Mailing Address - Fax:
Practice Address - Street 1:803 7TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2117
Practice Address - Country:US
Practice Address - Phone:304-523-1164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2257225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist