Provider Demographics
NPI:1649547662
Name:SANDHU, DIVYA KAUR (OTR/L)
Entity type:Individual
Prefix:MS
First Name:DIVYA
Middle Name:KAUR
Last Name:SANDHU
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6818 TERRACE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44134-4589
Mailing Address - Country:US
Mailing Address - Phone:440-281-0655
Mailing Address - Fax:
Practice Address - Street 1:7377 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44129-6602
Practice Address - Country:US
Practice Address - Phone:440-845-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-18
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.007902225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist