Provider Demographics
NPI:1255612057
Name:WALZ, CINDA A (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:CINDA
Middle Name:A
Last Name:WALZ
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 1:7901 POPLAR AVE
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-5006
Mailing Address - Country:US
Mailing Address - Phone:901-758-2228
Mailing Address - Fax:901-531-6735
Practice Address - Street 1:7901 POPLAR AVE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-5006
Practice Address - Country:US
Practice Address - Phone:901-758-2228
Practice Address - Fax:901-531-6735
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP4315235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist