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General NPI Number Information
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NPI Number | 1235480187
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Entity Type | Individual
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Provider Name | CYNTHEA CLARK BC-HIS
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Gender | Female
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Dates
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Enumeration Date | 10/01/2012
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 8935 S PECOS RD STE 21A
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City | HENDERSON
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State | NV
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Zip | 89074-7155
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Country | US
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Telephone | 725-333-4327
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Fax | 702-921-6370
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Provider Business Mailing Address
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Address Line | 8935 S PECOS RD STE 21A
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City | HENDERSON
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State | NV
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Zip | 89074-7155
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Country | US
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Telephone | 725-333-4327
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Fax | 702-921-6370
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | HAS-513
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License Number State | NV
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