Provider Demographics
NPI:1255562112
Name:EBERWEIN, CINDI LYNN (OTR/L, MS)
Entity type:Individual
Prefix:
First Name:CINDI
Middle Name:LYNN
Last Name:EBERWEIN
Suffix:
Gender:F
Credentials:OTR/L, MS
Other - Prefix:
Other - First Name:CINDI
Other - Middle Name:LYNN
Other - Last Name:SHARPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L, MS
Mailing Address - Street 1:409 WINDY KNOLL DR.
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771
Mailing Address - Country:US
Mailing Address - Phone:410-812-5623
Mailing Address - Fax:
Practice Address - Street 1:37 MAIN ST.
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136
Practice Address - Country:US
Practice Address - Phone:410-526-7882
Practice Address - Fax:410-526-9855
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06311225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD404353700Medicaid