Provider Demographics
NPI:1871063107
Name:REGE, SUDNYA (MS, OTR/L, CLT)
Entity type:Individual
Prefix:
First Name:SUDNYA
Middle Name:
Last Name:REGE
Suffix:
Gender:F
Credentials:MS, OTR/L, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3802 KNIGHTBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-4531
Mailing Address - Country:US
Mailing Address - Phone:732-986-0992
Mailing Address - Fax:
Practice Address - Street 1:38200 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1700
Practice Address - Country:US
Practice Address - Phone:586-274-9044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist