Provider Demographics
NPI:1831165786
Name:WEAVER, CYNTHIA EILEEN (OTR L)
Entity type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:EILEEN
Last Name:WEAVER
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 1:313 CHEVY CHASE DR
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-9365
Mailing Address - Country:US
Mailing Address - Phone:419-468-6244
Mailing Address - Fax:
Practice Address - Street 1:565 CHILDRENS DR W
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2648
Practice Address - Country:US
Practice Address - Phone:614-228-5523
Practice Address - Fax:614-443-1848
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH006477225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist