Cynthia Kyle
Individual provider Active NPI Developmental Therapist · Grovetown, PA
NPI 1003172289 · NPPES record last updated May 1, 2013
Key facts
- NPI
- 1003172289
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 3317 Gordon Highway
Grovetown, PA 19382 - Phone
- (111) 111-1111
- NPI assigned
- Apr 2, 2012
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
3317 Gordon Highway
Grovetown, PA 19382
Mailing address
3317 Gordon Highway
Grovetown, PA 19382
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | GA | 22 RESPIRATORY, DEVELOPMENTAL SERVICE PROVIDERS |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.