Provider Demographics
NPI:1801944673
Name:STANNARD, CYNTHIA RISHEL (AT,C)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:RISHEL
Last Name:STANNARD
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Gender:F
Credentials:AT,C
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Mailing Address - Street 1:31055 BEACHWALK DR
Mailing Address - Street 2:APT. 2903
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-1424
Mailing Address - Country:US
Mailing Address - Phone:248-669-1985
Mailing Address - Fax:
Practice Address - Street 1:39830 GRAND RIVER AVE
Practice Address - Street 2:SUITE B3
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2140
Practice Address - Country:US
Practice Address - Phone:248-473-5600
Practice Address - Fax:248-473-8480
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer