Provider Demographics
NPI:1487009692
Name:MOSER, CYNTHIA
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:
Last Name:MOSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-1452
Mailing Address - Country:US
Mailing Address - Phone:330-482-1375
Mailing Address - Fax:330-482-1375
Practice Address - Street 1:930 E PARK AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-1452
Practice Address - Country:US
Practice Address - Phone:330-482-1375
Practice Address - Fax:330-482-1375
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.7871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist