Provider Demographics
NPI:1164561023
Name:CARON, CINDI RAE (LMBT)
Entity Type:Individual
Prefix:
First Name:CINDI
Middle Name:RAE
Last Name:CARON
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 OWEN RD
Mailing Address - Street 2:
Mailing Address - City:BLOWING ROCK
Mailing Address - State:NC
Mailing Address - Zip Code:28605-8926
Mailing Address - Country:US
Mailing Address - Phone:828-295-8973
Mailing Address - Fax:
Practice Address - Street 1:276 SUNSET DR
Practice Address - Street 2:
Practice Address - City:BLOWING ROCK
Practice Address - State:NC
Practice Address - Zip Code:28605-7206
Practice Address - Country:US
Practice Address - Phone:828-773-5126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4990225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist