Provider Demographics
NPI:1619069358
Name:HALL, CINNDIE L (OTR/L)
Entity Type:Individual
Prefix:
First Name:CINNDIE
Middle Name:L
Last Name:HALL
Suffix:
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 1:720 LINDSAY LN
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-4103
Mailing Address - Country:US
Mailing Address - Phone:307-578-1970
Mailing Address - Fax:307-578-1973
Practice Address - Street 1:720 LINDSAY LN
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-4103
Practice Address - Country:US
Practice Address - Phone:307-578-1970
Practice Address - Fax:307-578-1973
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYOTR-450225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY315267OtherBLUE CROSS BLUE SHIELD
WA196654OtherWORK COMP
WY315267OtherBLUE CROSS BLUE SHIELD
WA196654OtherWORK COMP