Provider Demographics
NPI:1427642784
Name:SUNDQUIST, HEIDI INGA-BRITT (OTR/L)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:INGA-BRITT
Last Name:SUNDQUIST
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 1:7711 SKY VISTA PKWY UNIT 2321
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-2267
Mailing Address - Country:US
Mailing Address - Phone:530-949-2100
Mailing Address - Fax:
Practice Address - Street 1:1565 VIRGINIA RANCH RD
Practice Address - Street 2:
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5704
Practice Address - Country:US
Practice Address - Phone:775-782-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOT-2681225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty