MEDICARE: CINDY LYNETTE MULANAX MA-CCC SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SLP-1115	WV

General Provider Information

NPI Number	:	1104633924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CINDY LYNETTE MULANAX MA-CCC SLP

Provider Business Mailing Address
First Line	:	1912 REDSTONE RD
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-9720
Country	:	US
Telephone Number	:	304-932-8233
Fax Number	:

Provider Business Practice Location Address
First Line	:	1912 REDSTONE RD
Second Line	:
City	:	SOUTH CHARLESTON
State	:	WV
Zip	:	25309-9720
Country	:	US
Telephone Number	:	304-932-8233
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	12/16/2024

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Directions to “ CINDY LYNETTE MULANAX MA-CCC SLP” Practice Location

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