Provider Demographics
NPI:1083080055
Name:PEW, CYNTHIA
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:PEW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 BROOKLYN ST
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8510
Mailing Address - Country:US
Mailing Address - Phone:802-888-6852
Mailing Address - Fax:802-888-0181
Practice Address - Street 1:481 BROOKLYN ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8510
Practice Address - Country:US
Practice Address - Phone:802-888-6852
Practice Address - Fax:802-888-0181
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT063.0100933237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist