Provider Demographics
NPI:1447423652
Name:MUNSHELL, CYNTHIA D (PHD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:MUNSHELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11120 NEW HAMPSHIRE AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-2633
Mailing Address - Country:US
Mailing Address - Phone:310-593-1315
Mailing Address - Fax:310-681-4699
Practice Address - Street 1:11120 NEW HAMPSHIRE AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-2633
Practice Address - Country:US
Practice Address - Phone:310-593-1315
Practice Address - Fax:310-681-4699
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02972103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical