Provider Demographics
NPI:1841409901
Name:PEARSON, CYNTHIA A (OTR/L)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:PEARSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:A
Other - Last Name:PEARSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR
Mailing Address - Street 1:687 W 450 N
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-9729
Mailing Address - Country:US
Mailing Address - Phone:765-681-2630
Mailing Address - Fax:
Practice Address - Street 1:1800 N WABASH RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-1300
Practice Address - Country:US
Practice Address - Phone:765-651-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31002300A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist