Provider Demographics
NPI:1750699674
Name:SPEAR, CINNAMON L (OTR/L)
Entity type:Individual
Prefix:
First Name:CINNAMON
Middle Name:L
Last Name:SPEAR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2750 MOUNT PLEASANT ST
Mailing Address - Street 2:STE 104
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-2136
Mailing Address - Country:US
Mailing Address - Phone:319-750-1911
Mailing Address - Fax:
Practice Address - Street 1:2750 MOUNT PLEASANT ST STE 104
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-2136
Practice Address - Country:US
Practice Address - Phone:319-750-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10-0049225X00000X
IA001894225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist