Provider Demographics
NPI:1881857258
Name:KUCHEL, STUART TODD (MS, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:STUART
Middle Name:TODD
Last Name:KUCHEL
Suffix:
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2114 GENTLE ST
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-9404
Mailing Address - Country:US
Mailing Address - Phone:307-899-2337
Mailing Address - Fax:307-587-9060
Practice Address - Street 1:502 19TH ST
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-3325
Practice Address - Country:US
Practice Address - Phone:307-899-2337
Practice Address - Fax:307-587-9060
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTR-255225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY117946200Medicaid
WY117946201Medicaid
WY311814OtherBLUE CROSS BLUE SHIELD