Provider Demographics
NPI:1861762726
Name:POLAKIEWICZ, CUTTING J (OT)
Entity type:Individual
Prefix:MRS
First Name:CUTTING
Middle Name:J
Last Name:POLAKIEWICZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 N BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-1602
Mailing Address - Country:US
Mailing Address - Phone:434-738-3341
Mailing Address - Fax:434-447-4941
Practice Address - Street 1:125 BUENA VISTA CIR
Practice Address - Street 2:RMI
Practice Address - City:SOUTH HILL
Practice Address - State:VA
Practice Address - Zip Code:23970-1431
Practice Address - Country:US
Practice Address - Phone:434-447-3151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAN11R00092497225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist