Provider Demographics
NPI:1346781473
Name:CHEW, DREAM MONG-TING (OTR/L)
Entity Type:Individual
Prefix:
First Name:DREAM
Middle Name:MONG-TING
Last Name:CHEW
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MONG-TING
Other - Middle Name:DREAM
Other - Last Name:CHEW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1271 N MAGNOLIA WAY
Mailing Address - Street 2:
Mailing Address - City:AZUSA
Mailing Address - State:CA
Mailing Address - Zip Code:91702-1478
Mailing Address - Country:US
Mailing Address - Phone:626-321-5043
Mailing Address - Fax:
Practice Address - Street 1:1271 N MAGNOLIA WAY
Practice Address - Street 2:
Practice Address - City:AZUSA
Practice Address - State:CA
Practice Address - Zip Code:91702-1478
Practice Address - Country:US
Practice Address - Phone:626-321-5043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17161225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist