Provider Demographics
NPI:1154360048
Name:FYNES, CASSANDRA MARION (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:MARION
Last Name:FYNES
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2058 S DOBSON RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6454
Mailing Address - Country:US
Mailing Address - Phone:480-456-0176
Mailing Address - Fax:480-730-6893
Practice Address - Street 1:2058 S DOBSON RD
Practice Address - Street 2:SUITE 10
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6454
Practice Address - Country:US
Practice Address - Phone:480-456-0176
Practice Address - Fax:480-730-6893
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1798237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ05310OtherHEAR USA, NECP
AZAZ0307030OtherBLUE CROSS BLUE SHIELD
AZAZ0307030OtherBLUE CROSS BLUE SHIELD