Provider Demographics
NPI:1942528633
Name:DZIALO, CYNTHYA (CLD, CHBE)
Entity Type:Individual
Prefix:MS
First Name:CYNTHYA
Middle Name:
Last Name:DZIALO
Suffix:
Gender:F
Credentials:CLD, CHBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 WELLSWOOD DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-4515
Mailing Address - Country:US
Mailing Address - Phone:678-575-3742
Mailing Address - Fax:
Practice Address - Street 1:1565 WELLSWOOD DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30315-4515
Practice Address - Country:US
Practice Address - Phone:678-575-3742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator