Healthcare Provider Details

I. General information

NPI: 1366752503
Provider Name (Legal Business Name): CYNTHIA B SIMONDS PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2010
Last Update Date: 11/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 PAOLI PIKE
MALVERN PA
19355-3311
US

IV. Provider business mailing address

414 PAOLI PIKE
MALVERN PA
19355-3311
US

V. Phone/Fax

Practice location:
  • Phone: 484-596-5430
  • Fax:
Mailing address:
  • Phone: 484-596-5605
  • Fax: 610-296-3788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS016042
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35S100472500
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPS016042
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS016042
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: