Provider Demographics
NPI:1972934818
Name:HODOWAINE, CINDY (LPTA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:HODOWAINE
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31125 DEQUINDRE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071-1566
Mailing Address - Country:US
Mailing Address - Phone:586-582-8668
Mailing Address - Fax:586-582-8677
Practice Address - Street 1:31125 DEQUINDRE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1566
Practice Address - Country:US
Practice Address - Phone:586-582-8668
Practice Address - Fax:586-582-8677
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-03
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL2291051225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant