MEDICARE: CYNTHIA J HEARTY

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	2355S0801X	Speech-Language Assistant	SLPA12792	AZ
2	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1154910826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA J HEARTY

Provider Business Mailing Address
First Line	:	17309 W CARMEN DR
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85388-1230
Country	:	US
Telephone Number	:	602-327-1159
Fax Number	:

Provider Business Practice Location Address
First Line	:	17309 W CARMEN DR
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85388-1230
Country	:	US
Telephone Number	:	602-327-1159
Fax Number	:

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

Provider Enumeration Date	:	01/15/2021
Last Update Date	:	06/15/2026

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Directions to “ CYNTHIA J HEARTY ” Practice Location

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