MEDICARE: COURTNEY CYBULSKI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	30000959	NC

General Provider Information

NPI Number	:	1225761299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY CYBULSKI

Provider Business Mailing Address
First Line	:	3653 VILLAGE SPRINGS DR
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9455
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3653 VILLAGE SPRINGS DR
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-9455
Country	:	US
Telephone Number	:	716-374-5712
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2022
Last Update Date	:	07/06/2022

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Directions to “ COURTNEY CYBULSKI ” Practice Location

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