Provider Demographics
NPI:1912591769
Name:MITCHELL, CYNTHIA (OTR)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:MITCHELL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:MANGLIERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2425 LAFAYETTE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5975
Mailing Address - Country:US
Mailing Address - Phone:603-373-8512
Mailing Address - Fax:
Practice Address - Street 1:2425 LAFAYETTE RD STE 2
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5975
Practice Address - Country:US
Practice Address - Phone:603-373-8512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOTL14822225X00000X
NH3813225X00000X
WAOT61023263225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist