Provider Demographics
NPI:1053547216
Name:DEWYSOCKIE, CINDY L (LMT)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:DEWYSOCKIE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SE 6TH AVE APT 12G
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5272
Mailing Address - Country:US
Mailing Address - Phone:561-271-8036
Mailing Address - Fax:561-819-9908
Practice Address - Street 1:7561 N FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1603
Practice Address - Country:US
Practice Address - Phone:561-271-8036
Practice Address - Fax:561-819-9908
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA43636225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist