Provider Demographics
NPI:1396783296
Name:STAPLETON, CYNTHIA (MS, CCC-A)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:STAPLETON
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7069
Mailing Address - Country:US
Mailing Address - Phone:207-786-9949
Mailing Address - Fax:207-786-9948
Practice Address - Street 1:217 MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7069
Practice Address - Country:US
Practice Address - Phone:207-786-9949
Practice Address - Fax:207-786-9948
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2008-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAP1798231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist