Provider Demographics
NPI:1326224544
Name:GUGGEMOS, CHERYL ANN (OT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:GUGGEMOS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 TERRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-3028
Mailing Address - Country:US
Mailing Address - Phone:716-685-2243
Mailing Address - Fax:
Practice Address - Street 1:40 CENTRE DR
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-4100
Practice Address - Country:US
Practice Address - Phone:716-667-2294
Practice Address - Fax:716-667-2272
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0116551174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist