Provider Demographics
NPI:1851606057
Name:CYR, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:CYR
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 1:180 PRESQUE ISLE RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04732-0369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:180 PRESQUE ISLE RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:ME
Practice Address - Zip Code:04732-0369
Practice Address - Country:US
Practice Address - Phone:207-435-3661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1004235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MESP1004Medicare Oscar/Certification