Provider Demographics
NPI:1184210957
Name:HANCOCK-CARDEN, CINDY JURITUS
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:JURITUS
Last Name:HANCOCK-CARDEN
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 1:118 RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKNEAL
Mailing Address - State:VA
Mailing Address - Zip Code:24528-2835
Mailing Address - Country:US
Mailing Address - Phone:143-437-6696
Mailing Address - Fax:
Practice Address - Street 1:118 RIDGE ST
Practice Address - Street 2:
Practice Address - City:BROOKNEAL
Practice Address - State:VA
Practice Address - Zip Code:24528-2835
Practice Address - Country:US
Practice Address - Phone:143-437-6696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services