Provider Demographics
NPI:1639674674
Name:DELUCENAY, CYNTHIA DARLENE
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DARLENE
Last Name:DELUCENAY
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 1:7600 HALPRIN DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23518-4431
Mailing Address - Country:US
Mailing Address - Phone:757-531-3070
Mailing Address - Fax:757-531-3071
Practice Address - Street 1:7600 HALPRIN DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-4431
Practice Address - Country:US
Practice Address - Phone:757-531-3070
Practice Address - Fax:757-531-3071
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist