Provider Demographics
NPI:1104228824
Name:PACCONI, CYNTHIA (MA-CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:PACCONI
Suffix:
Gender:F
Credentials:MA-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 BROWNING CT N
Mailing Address - Street 2:
Mailing Address - City:EAST CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44730-1248
Mailing Address - Country:US
Mailing Address - Phone:330-488-0392
Mailing Address - Fax:
Practice Address - Street 1:310 BROWNING CT N
Practice Address - Street 2:
Practice Address - City:EAST CANTON
Practice Address - State:OH
Practice Address - Zip Code:44730-1248
Practice Address - Country:US
Practice Address - Phone:330-488-0392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5811235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist