Provider Demographics
NPI:1740835677
Name:KING, SYDNEY A (OTR/L)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:A
Last Name:KING
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:A
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2981 EDGEHILL RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2064
Mailing Address - Country:US
Mailing Address - Phone:513-508-1842
Mailing Address - Fax:
Practice Address - Street 1:2981 EDGEHILL RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2064
Practice Address - Country:US
Practice Address - Phone:513-508-1842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-07
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT010108225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist