Provider Demographics
NPI:1104199827
Name:GUYNES, CORDIE
Entity Type:Individual
Prefix:
First Name:CORDIE
Middle Name:
Last Name:GUYNES
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 1:5928 POST MOUNTAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-6891
Mailing Address - Country:US
Mailing Address - Phone:702-574-9625
Mailing Address - Fax:
Practice Address - Street 1:5928 POST MOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-6891
Practice Address - Country:US
Practice Address - Phone:702-574-9625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation TherapistGroup - Single Specialty