Provider Demographics
NPI:1609014844
Name:VIGIL, CYNTHIA SUE (MA, F-AAA)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:SUE
Last Name:VIGIL
Suffix:
Gender:F
Credentials:MA, F-AAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 GINNALA DRIVE, #3
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538
Mailing Address - Country:US
Mailing Address - Phone:970-593-1509
Mailing Address - Fax:970-593-6810
Practice Address - Street 1:2902 GINNALA DR STE 3
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-7818
Practice Address - Country:US
Practice Address - Phone:970-593-1509
Practice Address - Fax:970-593-6810
Is Sole Proprietor?:No
Enumeration Date:2009-01-26
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO461231H00000X, 231HA2400X, 231HA2500X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO15970051Medicaid
CO15970051Medicaid