Provider Demographics
NPI:1417409897
Name:TEMPLE, CYNTHIA
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:TEMPLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:
Other - Last Name:TEMPLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HIS
Mailing Address - Street 1:1485 N DYSART RD
Mailing Address - Street 2:#104
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85323-1546
Mailing Address - Country:US
Mailing Address - Phone:623-935-5277
Mailing Address - Fax:623-932-3516
Practice Address - Street 1:1485 N DYSART RD
Practice Address - Street 2:#104
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-1546
Practice Address - Country:US
Practice Address - Phone:623-935-5277
Practice Address - Fax:623-932-3516
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8392237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist