Provider Demographics
NPI:1932260163
Name:METCALF, CYNTHIA ANN (OT)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:METCALF
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:CYNTHIA
Other - Middle Name:ANN
Other - Last Name:ROBERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:308 RALEIGH ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27565-3340
Mailing Address - Country:US
Mailing Address - Phone:919-693-8847
Mailing Address - Fax:919-693-1620
Practice Address - Street 1:209 E MCCLANAHAN ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NC
Practice Address - Zip Code:27565-2921
Practice Address - Country:US
Practice Address - Phone:919-693-6647
Practice Address - Fax:919-693-1620
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6531225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCGROUP 1556UOtherBCBSOF NC
NC7302198Medicaid