Provider Demographics
NPI:1013499631
Name:FLANARY, CYNTHIA TURNER (OTR)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:TURNER
Last Name:FLANARY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 COUNTY ROAD 2364
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:TX
Mailing Address - Zip Code:75436-3105
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 COUNTY ROAD 2364
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:TX
Practice Address - Zip Code:75436-3105
Practice Address - Country:US
Practice Address - Phone:903-249-8322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103676225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist