Provider Demographics
NPI:1356474431
Name:CARTER, CYNTHIA JANELLE (MS,CCC,SLP)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:JANELLE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MS,CCC,SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211A IRELAND DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3372
Mailing Address - Country:US
Mailing Address - Phone:910-486-1605
Mailing Address - Fax:
Practice Address - Street 1:1211A IRELAND DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3372
Practice Address - Country:US
Practice Address - Phone:910-486-1605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1582235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1385WOtherBLUE CROSS BLUE SHIELD NC