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Individual

MS. CYNTHIA YVETTE STORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
201 LAMKIN ST, UNIT 101B, PUEBLO, CO 81003-3476
(719) 353-7727
(719) 253-7729
Mailing address
380 W BALDWYN DR, PUEBLO WEST, CO 81007-2823
(719) 547-0275

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
29750521
CO
Enumeration date
09/04/2012
Last updated
09/04/2012
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