Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 4566 | WI |
NPI | 1003000787 |
---|---|
Provider Name | Cyndi Anne Hyde |
First Address | Albany, OR 97322-8877 |
Second Address | Heathrow, FL 32746-5352 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2007 |
Last Update Date | 05/09/2007 |