Individual
MRS. HEIDI DAWN SUTCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20711 BROADWATER DR, LAND O LAKES, FL 34638-8324
(813) 789-5252
(813) 909-8270
Mailing address
20711 BROADWATER DR, LAND O LAKES, FL 34638-8324
(813) 789-5252
(813) 909-8270
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811639300
—
FL
Enumeration date
11/29/2006
Last updated
02/27/2019
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