Provider Demographics
NPI:1407130321
Name:SEPIASHVILY, CINDY (MS SLP)
Entity Type:Individual
Prefix:MISS
First Name:CINDY
Middle Name:
Last Name:SEPIASHVILY
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 E 12TH ST APT 5L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1033
Mailing Address - Country:US
Mailing Address - Phone:917-574-1957
Mailing Address - Fax:
Practice Address - Street 1:1745 E 12TH ST APT 5L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1033
Practice Address - Country:US
Practice Address - Phone:917-574-1957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021438-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist