Provider Demographics
NPI:1932245727
Name:HYMAN, CYNTHIA JO (MA CCCA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:JO
Last Name:HYMAN
Suffix:
Gender:F
Credentials:MA CCCA
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:HYMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA CCCA
Mailing Address - Street 1:75 W COMMERCIAL ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-4797
Mailing Address - Country:US
Mailing Address - Phone:207-874-1065
Mailing Address - Fax:207-874-1068
Practice Address - Street 1:75 W COMMERCIAL ST
Practice Address - Street 2:SUITE 205
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-4797
Practice Address - Country:US
Practice Address - Phone:207-874-1065
Practice Address - Fax:207-874-1068
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP573231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME313330099Medicaid
ME044511OtherANTHEM BCBS