Provider Demographics
NPI:1598827917
Name:HOLBROOK, CYNTHIA F (MS 2MHP)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:F
Last Name:HOLBROOK
Suffix:
Gender:F
Credentials:MS 2MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 N NORDICA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60707
Mailing Address - Country:US
Mailing Address - Phone:773-745-5523
Mailing Address - Fax:
Practice Address - Street 1:6415 STANLEY AVENUE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402
Practice Address - Country:US
Practice Address - Phone:708-788-0511
Practice Address - Fax:708-788-0831
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker