Provider Demographics
NPI:1922132265
Name:CRITTENDEN-HENDERSON, CINDY A (LDO)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:A
Last Name:CRITTENDEN-HENDERSON
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 HIGHWAY 153
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-4912
Mailing Address - Country:US
Mailing Address - Phone:423-877-9990
Mailing Address - Fax:423-875-9952
Practice Address - Street 1:5301 HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4912
Practice Address - Country:US
Practice Address - Phone:423-877-9990
Practice Address - Fax:423-875-9952
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN692156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician