Provider Demographics
NPI:1497957708
Name:MACKEY, CYNTHIA ANNE (OT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:ANNE
Last Name:MACKEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:CYNTHIA
Other - Middle Name:ANNE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:15130 SUMMIT PLACE CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-4107
Mailing Address - Country:US
Mailing Address - Phone:239-248-7873
Mailing Address - Fax:239-348-7887
Practice Address - Street 1:5860 GOLDEN GATE PKWY
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-7459
Practice Address - Country:US
Practice Address - Phone:239-455-9525
Practice Address - Fax:239-455-2844
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 110252251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics