Provider Demographics
NPI:1942921903
Name:VANESSA HEMINGWAY, OTR LLC
Entity Type:Organization
Organization Name:VANESSA HEMINGWAY, OTR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HEMINGWAY
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:831-515-2945
Mailing Address - Street 1:737 N BRANCIFORTE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-1050
Mailing Address - Country:US
Mailing Address - Phone:831-515-2945
Mailing Address - Fax:
Practice Address - Street 1:737 N BRANCIFORTE AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-1050
Practice Address - Country:US
Practice Address - Phone:831-515-2945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty