Provider Demographics
NPI:1528539350
Name:CUNNINGHAM, LINDA DOUGLAS I (OTR/L)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:DOUGLAS
Last Name:CUNNINGHAM
Suffix:I
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 NEW HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-5606
Mailing Address - Country:US
Mailing Address - Phone:717-606-1865
Mailing Address - Fax:717-606-1995
Practice Address - Street 1:1020 NEW HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-5606
Practice Address - Country:US
Practice Address - Phone:717-606-1865
Practice Address - Fax:717-606-1995
Is Sole Proprietor?:No
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001170L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist