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General NPI Number Information
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NPI Number | 1700351517
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Entity Type | Individual
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Provider Name | CYNTHIA C. BREWSTER MS-CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 107 OAK GROVE LN APT 2103
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City | EATONTON
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State | GA
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Zip | 31024-5059
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Country | US
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Telephone | 312-833-1028
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Fax | 855-361-1618
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Provider Business Mailing Address
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Address Line | 107 OAK GROVE LN APT 2103
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City | EATONTON
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State | GA
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Zip | 31024-5059
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Country | US
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Telephone | 312-833-1028
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Fax | 855-361-1618
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 02875
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146003496
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP007850
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License Number State | GA
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