Provider Demographics
NPI:1821465931
Name:GABLE, CYNTHIA L (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:GABLE
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 1:405 NW WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5432
Mailing Address - Country:US
Mailing Address - Phone:580-536-7991
Mailing Address - Fax:
Practice Address - Street 1:405 NW WOODLAND DR
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5432
Practice Address - Country:US
Practice Address - Phone:580-536-7991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2913235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist