Provider Demographics
NPI:1346801875
Name:MONROE, CINDY MARIE (CCC-SP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:MARIE
Last Name:MONROE
Suffix:
Gender:F
Credentials:CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MUNSON MEDICAL CENTER
Mailing Address - Street 2:1105 SIXTH STREET
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684
Mailing Address - Country:US
Mailing Address - Phone:231-935-7339
Mailing Address - Fax:231-935-7344
Practice Address - Street 1:MUNSON MEDICAL CENTER
Practice Address - Street 2:1105 SIXTH STREET
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684
Practice Address - Country:US
Practice Address - Phone:231-935-7339
Practice Address - Fax:231-935-7344
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101001690235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist