Provider Demographics
NPI:1184180986
Name:DAVIS, CINDY ANN (OT/L)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:ANN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT/L
Mailing Address - Street 1:5573 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KEMP
Mailing Address - State:TX
Mailing Address - Zip Code:75143-5501
Mailing Address - Country:US
Mailing Address - Phone:972-741-8439
Mailing Address - Fax:855-505-7965
Practice Address - Street 1:5573 CEDAR CREEK DR
Practice Address - Street 2:
Practice Address - City:KEMP
Practice Address - State:TX
Practice Address - Zip Code:75143-5501
Practice Address - Country:US
Practice Address - Phone:972-741-8439
Practice Address - Fax:855-505-7965
Is Sole Proprietor?:No
Enumeration Date:2019-02-17
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108760225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist