Provider Demographics
NPI:1093106882
Name:MARRS, CYNTHIA DIANNE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DIANNE
Last Name:MARRS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-2845
Mailing Address - Country:US
Mailing Address - Phone:817-219-1256
Mailing Address - Fax:
Practice Address - Street 1:119 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-2845
Practice Address - Country:US
Practice Address - Phone:817-219-1256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-15
Last Update Date:2015-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70649101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional