Provider Demographics
NPI:1558462457
Name:LITCH, CYNTHIA A (OTR)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:LITCH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:A
Other - Last Name:DZIUBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:166 S RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6928
Mailing Address - Country:US
Mailing Address - Phone:603-626-5077
Mailing Address - Fax:603-626-5076
Practice Address - Street 1:166 S RIVER RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6928
Practice Address - Country:US
Practice Address - Phone:603-626-5077
Practice Address - Fax:603-626-5076
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0529225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3621886OtherAETNA HEALTHCARE
NH30413080Medicaid
NH4130793OtherMVP
NH13Y007530NH01OtherANTHEM
NHLI RE7858Medicare ID - Type Unspecified