Provider Demographics
NPI:1750674925
Name:HOUCK, CYNTHIA MARIE (MASLP-CF,MAE)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:MARIE
Last Name:HOUCK
Suffix:
Gender:F
Credentials:MASLP-CF,MAE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 TAIT ST
Mailing Address - Street 2:APT C
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-4952
Mailing Address - Country:US
Mailing Address - Phone:760-402-9961
Mailing Address - Fax:
Practice Address - Street 1:1120 TAIT ST
Practice Address - Street 2:APT C
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-4952
Practice Address - Country:US
Practice Address - Phone:760-402-9961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-22
Last Update Date:2011-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE 6517235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist