Provider Demographics
NPI:1760920862
Name:KIDNER, CINDY LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:LEE
Last Name:KIDNER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 GATEWAY BLVD STE 431
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-3627
Mailing Address - Country:US
Mailing Address - Phone:972-807-2525
Mailing Address - Fax:
Practice Address - Street 1:1701 GATEWAY BLVD STE 431
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3627
Practice Address - Country:US
Practice Address - Phone:972-807-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-08
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35106103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist