Basic Information
| Provider Information | |||||||||
| NPI: | 1952550246 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ANDERSON | ||||||||
| FirstName: | CINDY | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1102 SUNSET CT | ||||||||
| Address2: | |||||||||
| City: | NORTHFIELD | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550573255 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073013141 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1961 CARDINAL LN STE A | ||||||||
| Address2: | |||||||||
| City: | FARIBAULT | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550214354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5073332986 | ||||||||
| FaxNumber: | 5073332918 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2008 | ||||||||
| LastUpdateDate: | 09/11/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 103447 | MN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.