Provider Demographics
NPI:1770705113
Name:TYNDALL, CHERYL COLLINS (OT)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:COLLINS
Last Name:TYNDALL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6448 SENTRY OAKS DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-4545
Mailing Address - Country:US
Mailing Address - Phone:910-470-7835
Mailing Address - Fax:
Practice Address - Street 1:4610 HOLLY TREE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28409-8556
Practice Address - Country:US
Practice Address - Phone:910-859-8296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1480225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist