Provider Demographics
NPI:1427198464
Name:THORNBY, CINDY MARIE
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:MARIE
Last Name:THORNBY
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 1:22 S TALLOWBERRY DR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3460
Mailing Address - Country:US
Mailing Address - Phone:281-367-4690
Mailing Address - Fax:
Practice Address - Street 1:25511 BUDDE RD STE 2802
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-2388
Practice Address - Country:US
Practice Address - Phone:281-755-3561
Practice Address - Fax:281-367-4690
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60959101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191763503Medicaid
TX191763504Medicaid