Provider Demographics
NPI:1780268136
Name:ROYSTON, CYNTHIA ELIZABETH (BCBA, M ED)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELIZABETH
Last Name:ROYSTON
Suffix:
Gender:F
Credentials:BCBA, M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11079 DEEP COVE DR
Mailing Address - Street 2:
Mailing Address - City:TEGA CAY
Mailing Address - State:SC
Mailing Address - Zip Code:29708-9382
Mailing Address - Country:US
Mailing Address - Phone:704-458-2436
Mailing Address - Fax:
Practice Address - Street 1:11079 DEEP COVE DR
Practice Address - Street 2:
Practice Address - City:TEGA CAY
Practice Address - State:SC
Practice Address - Zip Code:29708-9382
Practice Address - Country:US
Practice Address - Phone:704-458-2436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-28774103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-17-28774OtherBOARD CERTIFIED BEHAVIOR ANALYST (BCBA)
SC290101OtherSPECIAL EDUCATION (MULTI-CATEGORICAL); PROFESSIONAL CERTIFICATE