Provider Demographics
NPI:1487713046
Name:RISKAS, CINDY MARIE
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:MARIE
Last Name:RISKAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26215 N 41ST WAY
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-8966
Mailing Address - Country:US
Mailing Address - Phone:602-909-3093
Mailing Address - Fax:
Practice Address - Street 1:26215 N 41ST WAY
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-8966
Practice Address - Country:US
Practice Address - Phone:602-909-3093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPL4475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist