Provider Demographics
NPI:1962661132
Name:VALENCIA-KIMBALL, CYNTHIA GUADALUPE (MS)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:GUADALUPE
Last Name:VALENCIA-KIMBALL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 WINEBERRY DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-4658
Mailing Address - Country:US
Mailing Address - Phone:702-286-5253
Mailing Address - Fax:702-799-7339
Practice Address - Street 1:7011 WINEBERRY DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4658
Practice Address - Country:US
Practice Address - Phone:702-286-5253
Practice Address - Fax:702-799-7339
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP216235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist