Provider Demographics
NPI:1730324179
Name:KEATING, CYNTHIA GROSS (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:GROSS
Last Name:KEATING
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, OTR/L
Mailing Address - Street 1:20 CHERRY AVENUS
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-0000
Mailing Address - Country:US
Mailing Address - Phone:484-241-1911
Mailing Address - Fax:
Practice Address - Street 1:20 CHERRY AVENUS
Practice Address - Street 2:
Practice Address - City:TRAPPE
Practice Address - State:PA
Practice Address - Zip Code:19426-0000
Practice Address - Country:US
Practice Address - Phone:484-241-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC010655225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist