Provider Demographics
NPI:1053505990
Name:MCCLURG, CYNTHIA LOUISE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LOUISE
Last Name:MCCLURG
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7281 SARAH STREET
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63143-2404
Mailing Address - Country:US
Mailing Address - Phone:314-932-1051
Mailing Address - Fax:
Practice Address - Street 1:7281 SARAH ST
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MO
Practice Address - Zip Code:63143-2404
Practice Address - Country:US
Practice Address - Phone:314-932-1051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009003016235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist