Provider Demographics
NPI:1215055389
Name:THOMAS, CYNTHIA R (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MS 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:PO BOX 1742
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-1742
Mailing Address - Country:US
Mailing Address - Phone:707-477-0069
Mailing Address - Fax:707-838-0707
Practice Address - Street 1:117 KNIGHT CT
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-8337
Practice Address - Country:US
Practice Address - Phone:707-477-0069
Practice Address - Fax:707-838-0707
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP10979235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist