Provider Demographics
NPI:1710153028
Name:FORSTER, CYNTHIA KNOLL (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:KNOLL
Last Name:FORSTER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 HEFFRON ST
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-5564
Mailing Address - Country:US
Mailing Address - Phone:715-346-4517
Mailing Address - Fax:715-346-2157
Practice Address - Street 1:1901 4TH AVE
Practice Address - Street 2:
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1909
Practice Address - Country:US
Practice Address - Phone:715-346-4517
Practice Address - Fax:715-346-2157
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI377-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42564900Medicaid