Provider Demographics
NPI:1386725588
Name:BURGE, CYNTHIA JEAN (OTR/L, CHT)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JEAN
Last Name:BURGE
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 W HIGH ST
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-5529
Mailing Address - Country:US
Mailing Address - Phone:410-392-7027
Mailing Address - Fax:410-392-5768
Practice Address - Street 1:111 W HIGH ST
Practice Address - Street 2:SUITE 112
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5529
Practice Address - Country:US
Practice Address - Phone:410-392-7027
Practice Address - Fax:410-392-5768
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02247225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist