Provider Demographics
NPI:1720206873
Name:ANOUAR, CYNTHIA ANN
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ANN
Last Name:ANOUAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 N ELLISON RD
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-9828
Mailing Address - Country:US
Mailing Address - Phone:405-969-3981
Mailing Address - Fax:
Practice Address - Street 1:1916 E PERKINS AVE
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-5804
Practice Address - Country:US
Practice Address - Phone:405-282-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility