Provider Demographics
NPI:1578690194
Name:STROUT, CYNTHIA BECHER
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:BECHER
Last Name:STROUT
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 1:1156 BOWMAN RD UNIT 102
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3803
Mailing Address - Country:US
Mailing Address - Phone:843-856-3784
Mailing Address - Fax:843-856-3788
Practice Address - Street 1:1156 BOWMAN RD UNIT 102
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3803
Practice Address - Country:US
Practice Address - Phone:843-856-3784
Practice Address - Fax:843-856-3788
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC 164951744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study