Provider Demographics
NPI:1861094005
Name:NGUYEN, CINDY (OTR/L)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:NGUYEN
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 1:1435 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55071-1271
Mailing Address - Country:US
Mailing Address - Phone:651-235-3656
Mailing Address - Fax:
Practice Address - Street 1:1435 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL PARK
Practice Address - State:MN
Practice Address - Zip Code:55071-1271
Practice Address - Country:US
Practice Address - Phone:651-235-3656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN106305225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist