Provider Demographics
NPI:1376913673
Name:MATE, CYNTHIA (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:MATE
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-5316
Mailing Address - Country:US
Mailing Address - Phone:978-844-4076
Mailing Address - Fax:
Practice Address - Street 1:245 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-5316
Practice Address - Country:US
Practice Address - Phone:978-844-4076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA131056235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist