Provider Demographics
NPI:1730305731
Name:DEMENDOZA, CINDY CRABTREE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CINDY
Middle Name:CRABTREE
Last Name:DEMENDOZA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:LEE
Other - Last Name:CRABTREE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:561 N LACLEDE STATION RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-2048
Mailing Address - Country:US
Mailing Address - Phone:314-475-5115
Mailing Address - Fax:314-475-5115
Practice Address - Street 1:801 N 11TH ST
Practice Address - Street 2:MEDICAID DEPARTMENT
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63101-1015
Practice Address - Country:US
Practice Address - Phone:314-345-2535
Practice Address - Fax:314-345-2653
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO996185225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics