Provider Demographics
NPI:1093083172
Name:DOUCETTE, CYNTHIA B
Entity Type:Individual
Prefix:MISS
First Name:CYNTHIA
Middle Name:B
Last Name:DOUCETTE
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 1:43 RICHMOND TER
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-9520
Mailing Address - Country:US
Mailing Address - Phone:207-233-0218
Mailing Address - Fax:866-588-4282
Practice Address - Street 1:158 ROSS RD
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-6532
Practice Address - Country:US
Practice Address - Phone:405-513-7150
Practice Address - Fax:866-588-4282
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT99225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist