Provider Demographics
NPI:1417343195
Name:COLWELL, CYNTHIA (MOT OTR/L)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:COLWELL
Suffix:
Gender:F
Credentials:MOT OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 MARTIN LUTHER KING JR HWY # 9022
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22807-1053
Mailing Address - Country:US
Mailing Address - Phone:540-568-4980
Mailing Address - Fax:
Practice Address - Street 1:755 MARTIN LUTHER KING JR HWY # 9022
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22807-1053
Practice Address - Country:US
Practice Address - Phone:540-568-4980
Practice Address - Fax:540-568-2645
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119005625225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics