Provider Demographics
NPI:1467086702
Name:CAYCEDO, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:CAYCEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:CRON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9650 US HIGHWAY 431 N
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:KY
Mailing Address - Zip Code:42330-5705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:635 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:LEITCHFIELD
Practice Address - State:KY
Practice Address - Zip Code:42754-1056
Practice Address - Country:US
Practice Address - Phone:270-287-0656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician