MEDICARE: CINDY DAVIDSON SLP

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	1607	KS

General Provider Information

NPI Number	:	1356472500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY DAVIDSON SLP

Provider Business Mailing Address
First Line	:	9614 CHARTWELL ST
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67205-1545
Country	:	US
Telephone Number	:	316-650-2891
Fax Number	:

Provider Business Practice Location Address
First Line	:	CLEARWATER
Second Line	:	620 E WOOD STREET
City	:	CLEARWATER
State	:	KS
Zip	:	67026-9757
Country	:	US
Telephone Number	:	620-584-2271
Fax Number	:	620-584-2277

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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Directions to “ CINDY DAVIDSON SLP” Practice Location

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