Provider Demographics
NPI:1376983650
Name:PEARSON, CINDY L (BC-HIS)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:L
Last Name:PEARSON
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:L
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BC-HIS
Mailing Address - Street 1:1415 PARKVEIW DR
Mailing Address - Street 2:STE 100
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301
Mailing Address - Country:US
Mailing Address - Phone:208-733-0601
Mailing Address - Fax:
Practice Address - Street 1:1415 PARKVEIW DR
Practice Address - Street 2:STE 100
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301
Practice Address - Country:US
Practice Address - Phone:208-733-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-01
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV344237700000X
IDHA2734237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist