Provider Demographics
NPI:1326415811
Name:CANTWELL, CYNTHIA LEI (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:LEI
Last Name:CANTWELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:LEI
Other - Last Name:DESANTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:2659 GRAHAM RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-3613
Mailing Address - Country:US
Mailing Address - Phone:330-730-1831
Mailing Address - Fax:
Practice Address - Street 1:2659 GRAHAM RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-3613
Practice Address - Country:US
Practice Address - Phone:330-730-1831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP7622235Z00000X
OHOH1330652235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist