Provider Demographics
NPI:1134516941
Name:FOSS, CYNTHIA DIANE
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:DIANE
Last Name:FOSS
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 1:17 GREGG STREET
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:NH
Mailing Address - Zip Code:03086-0107
Mailing Address - Country:US
Mailing Address - Phone:603-860-4706
Mailing Address - Fax:
Practice Address - Street 1:17 GREGG STREET
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:NH
Practice Address - Zip Code:03086-0107
Practice Address - Country:US
Practice Address - Phone:603-860-4706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-20
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist