Provider Demographics
NPI:1518005149
Name:PICHLER, CINDY BETH (AUD, CCC-A, FAAA)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:BETH
Last Name:PICHLER
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:BETH
Other - Last Name:GISTENSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:10650 SUFFOLK HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-3246
Mailing Address - Country:US
Mailing Address - Phone:847-636-8595
Mailing Address - Fax:
Practice Address - Street 1:1161 S VALLEY VIEW BLVD
Practice Address - Street 2:AUDIOLOGY
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1854
Practice Address - Country:US
Practice Address - Phone:702-486-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-03
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147-000039231H00000X
NVA-1937231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL3038OtherDSCC PROVIDER
NVA-1937OtherNEVADA SPEECH-LANGUAGE, AUDIOLOGY AND HEARING AID DISPENSER BOARD
IL147-000039OtherPROFESSIONAL LICENSE
ILCP62180299POtherEARLY INTERVENTION PROVID
IL01031665-02OtherASHA CERTIFICATION
IL01031665-02OtherASHA CERTIFICATION