Provider Demographics
NPI:1861707432
Name:LOFTON, CYNTHIA IRENE (PHD, CCC/SLP)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:IRENE
Last Name:LOFTON
Suffix:
Gender:F
Credentials:PHD, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11139 264TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56301-9411
Mailing Address - Country:US
Mailing Address - Phone:320-980-6951
Mailing Address - Fax:
Practice Address - Street 1:11139 264TH ST
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56301-9411
Practice Address - Country:US
Practice Address - Phone:320-980-6951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-08
Last Update Date:2010-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5778235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist