Provider Demographics
NPI:1194364018
Name:YZAGUIRRE, CYNTHIA OCHOA (LMHC, NCC)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:OCHOA
Last Name:YZAGUIRRE
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:IMMOKALEE
Mailing Address - State:FL
Mailing Address - Zip Code:34142-3819
Mailing Address - Country:US
Mailing Address - Phone:239-633-5305
Mailing Address - Fax:239-657-6225
Practice Address - Street 1:4851 TAMIAMI TRL N STE 200
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-3098
Practice Address - Country:US
Practice Address - Phone:239-633-5305
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL15721101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health