Provider Demographics
NPI:1841332699
Name:LANG, CIMBERLY A (OTR)
Entity type:Individual
Prefix:MRS
First Name:CIMBERLY
Middle Name:A
Last Name:LANG
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-1287
Mailing Address - Country:US
Mailing Address - Phone:816-649-3253
Mailing Address - Fax:816-649-3367
Practice Address - Street 1:804 ROSEWOOD DR
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-1287
Practice Address - Country:US
Practice Address - Phone:816-649-3253
Practice Address - Fax:816-649-3367
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005017966225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist