Provider Demographics
NPI:1588238950
Name:TAWNEY, CYNTHIA MICHELLE (ADT 2421)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MICHELLE
Last Name:TAWNEY
Suffix:
Gender:F
Credentials:ADT 2421
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1557 PATUXENT MANOR CT
Mailing Address - Street 2:
Mailing Address - City:DAVIDSONVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21035-2124
Mailing Address - Country:US
Mailing Address - Phone:443-716-6789
Mailing Address - Fax:
Practice Address - Street 1:2669A SOLOMONS ISLAND RD
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:MD
Practice Address - Zip Code:21037-1101
Practice Address - Country:US
Practice Address - Phone:443-440-5780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-19
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)