Provider Demographics
NPI:1811452295
Name:COGSWELL, CYNTHIA (MA, CCC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:COGSWELL
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 FAIRFIELD PL
Mailing Address - Street 2:
Mailing Address - City:MORAGA
Mailing Address - State:CA
Mailing Address - Zip Code:94556-2508
Mailing Address - Country:US
Mailing Address - Phone:925-998-8106
Mailing Address - Fax:
Practice Address - Street 1:975 N SAN CARLOS DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2256
Practice Address - Country:US
Practice Address - Phone:925-998-8106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-09
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP3640235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist