Provider Demographics
NPI:1699014266
Name:HEISTER, CYNTHIA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:HEISTER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 OBERLIN RD
Mailing Address - Street 2:
Mailing Address - City:THOMPSONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17094-8690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 OBERLIN RD
Practice Address - Street 2:
Practice Address - City:THOMPSONTOWN
Practice Address - State:PA
Practice Address - Zip Code:17094-8690
Practice Address - Country:US
Practice Address - Phone:717-513-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005893L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist