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General NPI Number Information
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NPI Number | 1093244451
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Entity Type | Individual
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Provider Name | SHANA CYNAMON
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Gender | Female
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Dates
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Enumeration Date | 06/08/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1801 N 37TH PL
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City | PHOENIX
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State | AZ
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Zip | 85008
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Country | US
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Telephone | 305-336-1287
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 N 37TH PL
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City | PHOENIX
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State | AZ
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Zip | 85008-3911
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Country | US
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Telephone | 305-336-1287
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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