Provider Demographics
NPI:1992834998
Name:SMITH, CINDRA REESER (MS OTL)
Entity Type:Individual
Prefix:MRS
First Name:CINDRA
Middle Name:REESER
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS OTL
Other - Prefix:
Other - First Name:CINDRA
Other - Middle Name:LYNN
Other - Last Name:REESER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9909 MEDICAL CENTER DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850
Mailing Address - Country:US
Mailing Address - Phone:240-864-6000
Mailing Address - Fax:240-864-6049
Practice Address - Street 1:9909 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850
Practice Address - Country:US
Practice Address - Phone:240-864-6000
Practice Address - Fax:240-864-6049
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05708225X00000X
VA225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist