Wellformed AI

NPI 1154554046 · live from the CMS NPI Registry

Cynthia K Detrow, M.S., CCC-SLP

Speech-Language Pathologist, in Homer, AK. National Provider Identifier 1154554046, active.

NPI record

NPI1154554046 Type 1 · individual
StatusActive
Primary specialtySpeech-Language Pathologist, 235Z00000X
Practice location3691 Ben Walters Ln Ste 4, Homer, AK 99603
Practice phone907-235-6044
EnumeratedAugust 26, 2009
Last updatedAugust 26, 2009
Sole proprietorNo

Taxonomies and licenses

TaxonomyCodeLicense
Speech-Language Pathologist, primary235Z00000X284 (AK)

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.