Provider Demographics
NPI:1508943168
Name:MACNAB, CYNTHIA LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:LEE
Last Name:MACNAB
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 1:305 RAVENDALE RD
Mailing Address - Street 2:
Mailing Address - City:PENNSYLVANIA FURNACE
Mailing Address - State:PA
Mailing Address - Zip Code:16865-9536
Mailing Address - Country:US
Mailing Address - Phone:814-268-6864
Mailing Address - Fax:
Practice Address - Street 1:229 W FOSTER AVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-4823
Practice Address - Country:US
Practice Address - Phone:814-238-1880
Practice Address - Fax:814-867-2794
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008652L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling