Provider Demographics
NPI:1124005509
Name:EDWARDS, CINDI (OT)
Entity Type:Individual
Prefix:MRS
First Name:CINDI
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CINDI
Other - Middle Name:
Other - Last Name:FRANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:WINNER
Mailing Address - State:SD
Mailing Address - Zip Code:57580-0435
Mailing Address - Country:US
Mailing Address - Phone:605-842-7188
Mailing Address - Fax:605-842-7189
Practice Address - Street 1:825 E 8TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:WINNER
Practice Address - State:SD
Practice Address - Zip Code:57580-2633
Practice Address - Country:US
Practice Address - Phone:605-842-7188
Practice Address - Fax:605-842-7189
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0600225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD15919OtherAVERA HEALTH PLAN
SD5836162OtherMEDICAID
SD4994329OtherWELLMARK
SD55655OtherSANDFORD HEALTH PLAN
SD5836160OtherMEDICAID
SD9255242OtherDAKOTA CARE
SD55655OtherSANDFORD HEALTH PLAN