Provider Demographics
NPI:1699972216
Name:BELK, CINDY CARROLL (OTR)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:CARROLL
Last Name:BELK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 MALDEN DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-3125
Mailing Address - Country:US
Mailing Address - Phone:843-292-8658
Mailing Address - Fax:
Practice Address - Street 1:901 E CHEVES ST
Practice Address - Street 2:SUITE 510
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2716
Practice Address - Country:US
Practice Address - Phone:843-777-6340
Practice Address - Fax:843-777-8165
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2668225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCTH1405Medicaid