Provider Demographics
NPI:1699813451
Name:CUMMINGS, SANDY K (OTR)
Entity Type:Individual
Prefix:
First Name:SANDY
Middle Name:K
Last Name:CUMMINGS
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 1:873 S UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3307
Mailing Address - Country:US
Mailing Address - Phone:303-263-0394
Mailing Address - Fax:720-379-6912
Practice Address - Street 1:873 S UNION BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-3307
Practice Address - Country:US
Practice Address - Phone:303-263-0394
Practice Address - Fax:720-379-6912
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO914373225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO60077531Medicaid