Basic Information
| Provider Information | |||||||||
| NPI: | 1295976959 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | DEWHURST | ||||||||
| FirstName: | CYNTHIA | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 129 VILLAGE HILL LN | ||||||||
| Address2: | |||||||||
| City: | NORTH KINGSTOWN | ||||||||
| State: | RI | ||||||||
| PostalCode: | 028527012 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013311350 | ||||||||
| FaxNumber: | 4012773366 | ||||||||
| Practice Location | |||||||||
| Address1: | 134 THURBERS AVE | ||||||||
| Address2: | C/O FAMILY SERVICE OF RHODE ISLAND, INC | ||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029054754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4013311350 | ||||||||
| FaxNumber: | 4012773366 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2009 | ||||||||
| LastUpdateDate: | 03/10/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SP00636 | RI | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.