Provider Demographics
NPI:1528534302
Name:LUONG, BICH THUY THI (OTR/L)
Entity Type:Individual
Prefix:
First Name:BICH THUY
Middle Name:THI
Last Name:LUONG
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:THUY
Other - Middle Name:
Other - Last Name:LUONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:850 BROADSTONE WAY APT 407
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-1633
Mailing Address - Country:US
Mailing Address - Phone:727-455-7771
Mailing Address - Fax:
Practice Address - Street 1:730 COURTLAND ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1316
Practice Address - Country:US
Practice Address - Phone:407-975-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19526225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist