Provider Demographics
NPI:1285193623
Name:TAYLOR, CYNTHIA ANITA
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANITA
Last Name:TAYLOR
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 1:11721 KEMP MILL RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1722
Mailing Address - Country:US
Mailing Address - Phone:301-649-8085
Mailing Address - Fax:301-649-8092
Practice Address - Street 1:11721 KEMP MILL RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-1722
Practice Address - Country:US
Practice Address - Phone:301-649-8085
Practice Address - Fax:301-649-8092
Is Sole Proprietor?:No
Enumeration Date:2019-03-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06375235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist