Provider Demographics
NPI:1871851410
Name:CUMINS, NANCY ANN (MA, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:CUMINS
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3543 OLD CONEJO RD
Mailing Address - Street 2:SUITE 102-B
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-2159
Mailing Address - Country:US
Mailing Address - Phone:805-522-9771
Mailing Address - Fax:805-492-0779
Practice Address - Street 1:3543 OLD CONEJO RD
Practice Address - Street 2:SUITE 102-B
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-2159
Practice Address - Country:US
Practice Address - Phone:805-522-9771
Practice Address - Fax:805-492-0779
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 7686235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist