Provider Demographics
NPI:1427310382
Name:GREENFIELD, CINDY KAY (COTA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:KAY
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:KAY
Other - Last Name:FEDJE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:4228 DIXON ST
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-0391
Mailing Address - Country:US
Mailing Address - Phone:970-221-5371
Mailing Address - Fax:
Practice Address - Street 1:5055 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-9401
Practice Address - Country:US
Practice Address - Phone:970-223-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAA484873225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology