Provider Demographics
NPI:1437394848
Name:LEGWAILA, CINDY LEE (MT-BC)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:LEE
Last Name:LEGWAILA
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 VALENTI COUNTRY EST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-2646
Mailing Address - Country:US
Mailing Address - Phone:607-435-4516
Mailing Address - Fax:
Practice Address - Street 1:131 VALENTI COUNTRY EST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2646
Practice Address - Country:US
Practice Address - Phone:607-435-4516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-14
Last Update Date:2008-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08564225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist