Provider Demographics
NPI:1841151990
Name:THULIN, CYNTHIA ELLEN
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ELLEN
Last Name:THULIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31A JUNE ST
Mailing Address - Street 2:
Mailing Address - City:EAST WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02032-1124
Mailing Address - Country:US
Mailing Address - Phone:781-879-9579
Mailing Address - Fax:
Practice Address - Street 1:31A JUNE ST
Practice Address - Street 2:
Practice Address - City:EAST WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02032-1124
Practice Address - Country:US
Practice Address - Phone:781-879-9579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist