Provider Demographics
NPI:1457764896
Name:HILL, CYNTHIA LEE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LEE
Last Name:HILL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1845 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 127
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3467
Mailing Address - Country:US
Mailing Address - Phone:909-890-9030
Mailing Address - Fax:909-890-4393
Practice Address - Street 1:855 N LARK ELLEN AVE
Practice Address - Street 2:SUITE J
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-1099
Practice Address - Country:US
Practice Address - Phone:626-331-8355
Practice Address - Fax:626-331-8165
Is Sole Proprietor?:No
Enumeration Date:2014-06-03
Last Update Date:2016-07-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA11550235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB245780Medicare PIN