Provider Demographics
NPI:1215242425
Name:LUNDY, CYNTHIA PATTEE (SLP-CCC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:PATTEE
Last Name:LUNDY
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2863 NW CROSSING DR STE 218
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-7190
Mailing Address - Country:US
Mailing Address - Phone:408-410-9872
Mailing Address - Fax:
Practice Address - Street 1:2863 NW CROSSING DR STE 218
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-7190
Practice Address - Country:US
Practice Address - Phone:541-728-3306
Practice Address - Fax:541-550-2912
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15499235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist