Healthcare Provider Details

I. General information

NPI: 1396783296
Provider Name (Legal Business Name): CYNTHIA STAPLETON M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 04/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

217 MAIN ST SUITE 301
LEWISTON ME
04240-7069
US

IV. Provider business mailing address

217 MAIN ST SUITE 301
LEWISTON ME
04240-7069
US

V. Phone/Fax

Practice location:
  • Phone: 207-786-9949
  • Fax: 207-786-9948
Mailing address:
  • Phone: 207-786-9949
  • Fax: 207-786-9948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAP1798
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: