Provider Demographics
NPI:1366777245
Name:CUFFE, KINDRA LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:KINDRA
Middle Name:LYNN
Last Name:CUFFE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4668 WINDCREST DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-9425
Mailing Address - Country:US
Mailing Address - Phone:775-829-4700
Mailing Address - Fax:775-829-4710
Practice Address - Street 1:3700 GRANT DR
Practice Address - Street 2:STE A
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5309
Practice Address - Country:US
Practice Address - Phone:775-829-4700
Practice Address - Fax:775-829-4710
Is Sole Proprietor?:No
Enumeration Date:2009-10-09
Last Update Date:2009-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV09-0178225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV296505Medicare PIN