Provider Demographics
NPI:1245442888
Name:CANOUT, SANDY BELLER (OT,PT,CFP,CHT)
Entity type:Individual
Prefix:MRS
First Name:SANDY
Middle Name:BELLER
Last Name:CANOUT
Suffix:
Gender:F
Credentials:OT,PT,CFP,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3638 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4118
Mailing Address - Country:US
Mailing Address - Phone:562-426-9797
Mailing Address - Fax:213-481-1518
Practice Address - Street 1:1200 WILSHIRE BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1908
Practice Address - Country:US
Practice Address - Phone:213-481-1515
Practice Address - Fax:213-481-1518
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT12641174400000X
CAOT6574174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist