Provider Demographics
NPI:1154660744
Name:WIGGINSPRELI, CYNTHIA HELENE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:HELENE
Last Name:WIGGINSPRELI
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8132 HUDSON AVE
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:FL
Mailing Address - Zip Code:34667-8571
Mailing Address - Country:US
Mailing Address - Phone:727-863-3100
Mailing Address - Fax:727-862-1479
Practice Address - Street 1:8132 HUDSON AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:FL
Practice Address - Zip Code:34667-8571
Practice Address - Country:US
Practice Address - Phone:727-863-3100
Practice Address - Fax:727-862-1479
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-03
Last Update Date:2013-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA10809224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant