Provider Demographics
NPI:1568080042
Name:CYD DAVIS-HUBLER LLC
Entity Type:Organization
Organization Name:CYD DAVIS-HUBLER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS-HUBLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:317-989-4579
Mailing Address - Street 1:4211 LOUISIANA BLVD NE APT 1121
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-1842
Mailing Address - Country:US
Mailing Address - Phone:317-989-4579
Mailing Address - Fax:
Practice Address - Street 1:9301 INDIAN SCHOOL RD NE STE 200F
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-2884
Practice Address - Country:US
Practice Address - Phone:505-308-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty