Provider Demographics
NPI:1043807803
Name:SANDHU, SUPREET KAUR (OTR/L)
Entity type:Individual
Prefix:
First Name:SUPREET
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 1:800 BENJAMIN FRANKLIN
Mailing Address - Street 2:UNIT 702
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34236
Mailing Address - Country:US
Mailing Address - Phone:718-570-2646
Mailing Address - Fax:
Practice Address - Street 1:800 BENJAMIN FRANKLIN DR., APT.702
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236
Practice Address - Country:US
Practice Address - Phone:718-570-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-28
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT24587225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty