Provider Demographics
NPI:1902017791
Name:O'NEAL, CINDY MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:MARIE
Last Name:O'NEAL
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 1:314 BRENTFORD AVE
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-4261
Mailing Address - Country:US
Mailing Address - Phone:563-271-3330
Mailing Address - Fax:
Practice Address - Street 1:314 BRENTFORD AVE
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-4261
Practice Address - Country:US
Practice Address - Phone:563-271-3330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146007366235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist