NPIMap

Cynthia Dale Blohm, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Jacksonville, AR

NPI 1013344159 · NPPES record last updated Oct 15, 2021

Key facts

NPI
1013344159
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
P8752 (AR)
Practice address
2400 W Main St
Jacksonville, AR 72076
Phone
(501) 982-0528
Fax
(501) 533-6326
NPI assigned
Oct 3, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

  • Pathfinder, Inc. Mental Health Clinic/Center (Including Community Mental Health Center) · Jacksonville, AR · NPI 1629035043
    NPD (past)

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
P8752ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathfinder, Inc. Past
since Oct 17, 2021		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X P8752 AR Yes

Addresses

Primary practice location

2400 W Main St
Jacksonville, AR 72076

Mailing address

2520 W Main St
Jacksonville, AR 72076
Phone (501) 982-0528

Other names

  • Cynthia Dale Dornblaser Former name

Other providers in Jacksonville, AR

All providers in Jacksonville, AR · Speech-Language Pathologist in Arkansas

Sources for this page

Verify at the official NPI Registry.