Provider Demographics
NPI:1093118424
Name:NESS, CYNTHIA KAYE (MA/CCC,SLP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:KAYE
Last Name:NESS
Suffix:
Gender:F
Credentials:MA/CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8006 100TH AVE S
Mailing Address - Street 2:
Mailing Address - City:HORACE
Mailing Address - State:ND
Mailing Address - Zip Code:58047-9779
Mailing Address - Country:US
Mailing Address - Phone:701-234-7173
Mailing Address - Fax:701-234-7391
Practice Address - Street 1:801 BROADWAY N
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58102-3641
Practice Address - Country:US
Practice Address - Phone:701-234-6970
Practice Address - Fax:701-234-7391
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND455235Z00000X
MN7857235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist