Provider Demographics
NPI:1922075605
Name:COOPER, CYNTHIA (MA, OTR/L, CHT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:COOPER
Suffix:
Gender:F
Credentials:MA, OTR/L, CHT
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:COOPER
Other - Last Name:EVARTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, OTR/L, CHT
Mailing Address - Street 1:8541 EAST ANDERSON DRIVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5430
Mailing Address - Country:US
Mailing Address - Phone:480-585-6810
Mailing Address - Fax:480-585-6910
Practice Address - Street 1:8541 EAST ANDERSON DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5430
Practice Address - Country:US
Practice Address - Phone:480-585-6810
Practice Address - Fax:480-585-6910
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ900225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ120536Medicare PIN
AZ0844880001Medicare NSC