Healthcare Provider Details

I. General information

NPI: 1043258742
Provider Name (Legal Business Name): CINDY MARIE HRDI M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CINDY MARIE LUND M.S., CCC-SLP

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2025 E NEWPORT AVE
MILWAUKEE WI
53211-2906
US

IV. Provider business mailing address

2912 S 45TH ST
MILWAUKEE WI
53219-3412
US

V. Phone/Fax

Practice location:
  • Phone: 414-961-4160
  • Fax:
Mailing address:
  • Phone: 414-727-4751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2286154
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: