MEDICARE: MRS. CINDY MARIE CRIPE OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	102669	MN

General Provider Information

NPI Number	:	1407823529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CINDY MARIE CRIPE OTR/L

Provider Business Mailing Address
First Line	:	6504 RIVER RIDGE LN
Second Line	:
City	:	MONTICELLO
State	:	MN
Zip	:	55362-3620
Country	:	US
Telephone Number	:	763-213-5842
Fax Number	:

Provider Business Practice Location Address
First Line	:	8511 JEFFERSON LN N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55445-2121
Country	:	US
Telephone Number	:	763-494-4438
Fax Number	:	763-494-4692

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	07/08/2007

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