MEDICARE: CYNTHIA STAPLETON M.S., CCC-A

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	231H00000X	Audiologist	AP1798	ME

General Provider Information

NPI Number	:	1396783296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA STAPLETON M.S., CCC-A

Provider Business Mailing Address
First Line	:	217 MAIN ST
Second Line	:	SUITE 301
City	:	LEWISTON
State	:	ME
Zip	:	04240-7069
Country	:	US
Telephone Number	:	207-786-9949
Fax Number	:	207-786-9948

Provider Business Practice Location Address
First Line	:	217 MAIN ST
Second Line	:	SUITE 301
City	:	LEWISTON
State	:	ME
Zip	:	04240-7069
Country	:	US
Telephone Number	:	207-786-9949
Fax Number	:	207-786-9948

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	04/21/2008

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