Provider Demographics
NPI:1962616300
Name:ALLEN, CYNTHIA NEWCOMB (OTR)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:NEWCOMB
Last Name:ALLEN
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 1:55 GALA DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24019-8038
Mailing Address - Country:US
Mailing Address - Phone:434-534-2766
Mailing Address - Fax:
Practice Address - Street 1:2001 RIDGEWOOD DR
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-7126
Practice Address - Country:US
Practice Address - Phone:540-378-4120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003474225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist