Provider Demographics
NPI:1194851899
Name:POE, CINDY S (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:S
Last Name:POE
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:POE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:GUIDANCE COUNSELOR
Mailing Address - Street 1:14804 W CHARTER OAK RD
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5927
Mailing Address - Country:US
Mailing Address - Phone:623-298-7383
Mailing Address - Fax:
Practice Address - Street 1:14804 W CHARTER OAK RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-5927
Practice Address - Country:US
Practice Address - Phone:623-298-7383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103TS0200X, 101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool