Provider Demographics
NPI:1275865743
Name:KENT, CYNTHIA MARIE (PSYD, BCIA-EEG)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:MARIE
Last Name:KENT
Suffix:
Gender:F
Credentials:PSYD, BCIA-EEG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 LAKE COOK RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-5646
Mailing Address - Country:US
Mailing Address - Phone:847-945-5095
Mailing Address - Fax:847-945-5060
Practice Address - Street 1:420 LAKE COOK RD
Practice Address - Street 2:SUITE 108
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-5646
Practice Address - Country:US
Practice Address - Phone:847-945-5095
Practice Address - Fax:847-945-5060
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist