MEDICARE: CYNTHIA GALT MA CCC

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	SP3308	CA

General Provider Information

NPI Number	:	1285666529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA GALT MA CCC

Provider Business Mailing Address
First Line	:	3880 S BASCOM AVE STE 116
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2600
Country	:	US
Telephone Number	:	408-377-7204
Fax Number	:	408-377-7208

Provider Business Practice Location Address
First Line	:	3880 S BASCOM AVE STE 116
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95124-2600
Country	:	US
Telephone Number	:	408-377-7204
Fax Number	:	408-377-7208

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

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	07/08/2007

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Directions to “ CYNTHIA GALT MA CCC” Practice Location

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