Provider Demographics
NPI:1427357789
Name:NOLEN, CYNTHIA ALICE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ALICE
Last Name:NOLEN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 N ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-7672
Mailing Address - Country:US
Mailing Address - Phone:405-550-0357
Mailing Address - Fax:
Practice Address - Street 1:2901 N ANDERSON RD
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-7672
Practice Address - Country:US
Practice Address - Phone:405-550-0357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2846235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist