Healthcare Provider Details

I. General information

NPI: 1124167036
Provider Name (Legal Business Name): CYNTHIA NARDELLI M.S.,CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 ROSEBUD PLZ
CLARKSBURG WV
26301-9386
US

IV. Provider business mailing address

620 ROSEBUD PLZ
CLARKSBURG WV
26301-9386
US

V. Phone/Fax

Practice location:
  • Phone: 304-622-1837
  • Fax: 304-326-3430
Mailing address:
  • Phone: 304-622-1837
  • Fax: 304-326-3430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA-0059
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberA-0059
License Number StateWV
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License NumberA-0059
License Number StateWV
# 4
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-0059
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: