Provider Demographics
NPI:1306871819
Name:DUNDAS, CYNTHIA LYNN (MS CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LYNN
Last Name:DUNDAS
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:LYNN
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC/SLP
Mailing Address - Street 1:14824 N 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-5173
Mailing Address - Country:US
Mailing Address - Phone:224-715-2556
Mailing Address - Fax:
Practice Address - Street 1:14824 N 15TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-5173
Practice Address - Country:US
Practice Address - Phone:224-715-2556
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006750235Z00000X
AZSLP10919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist