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General NPI Number Information
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NPI Number | 1194977280
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Entity Type | Individual
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Provider Name | CYNTHIA ANN SCOGGIN L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 10065 US HIGHWAY 98 W STE C101
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City | MIRAMAR BEACH
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State | FL
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Zip | 32550-4924
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Country | US
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Telephone | 850-830-6116
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Fax |
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Provider Business Mailing Address
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Address Line | 134 S 3RD ST
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City | SANTA ROSA BEACH
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State | FL
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Zip | 32459-3956
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Country | US
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Telephone | 850-830-6116
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA #45005
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License Number State | FL
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