Provider Demographics
NPI:1851627632
Name:ELLIOTT, CYNTHIA KREITER (OTR)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:KREITER
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:KREITER
Other - Last Name:BERTRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:151 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SPRING ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49283-9647
Mailing Address - Country:US
Mailing Address - Phone:517-750-1900
Mailing Address - Fax:
Practice Address - Street 1:151 2ND ST
Practice Address - Street 2:
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9647
Practice Address - Country:US
Practice Address - Phone:517-750-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201000098225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist