Provider Demographics
NPI:1023360286
Name:BERNETT, CYNTHIA VALDERREY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:VALDERREY
Last Name:BERNETT
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 1:10636 RIPPLING STREAM DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-8264
Mailing Address - Country:US
Mailing Address - Phone:980-248-1734
Mailing Address - Fax:
Practice Address - Street 1:10636 RIPPLING STREAM DR NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8264
Practice Address - Country:US
Practice Address - Phone:980-248-1734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist