Provider Demographics
NPI:1326218983
Name:CAMACHO, CYNTHIA A (OT)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:CAMACHO
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 SW 10TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1995
Mailing Address - Country:US
Mailing Address - Phone:785-272-4060
Mailing Address - Fax:785-272-7912
Practice Address - Street 1:3500 SW 10TH AVENUE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1995
Practice Address - Country:US
Practice Address - Phone:785-272-4060
Practice Address - Fax:785-272-7912
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1700362225X00000X
KS17-00362225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist