Provider Demographics
NPI:1700398930
Name:DAVIS, CYNTHIA KAY
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:KAY
Last Name:DAVIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:KAY
Other - Last Name:MCCRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:780 AMERICAN LEGION HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-3312
Mailing Address - Country:US
Mailing Address - Phone:917-469-8500
Mailing Address - Fax:617-469-8691
Practice Address - Street 1:780 AMERICAN LEGION HIGHWAY
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-3312
Practice Address - Country:US
Practice Address - Phone:617-469-8500
Practice Address - Fax:617-469-8691
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker