Provider Demographics
NPI:1790490498
Name:AMAYA-RECINOS, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:AMAYA-RECINOS
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 1:8416 XERXES AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55444-1469
Mailing Address - Country:US
Mailing Address - Phone:651-493-5102
Mailing Address - Fax:651-666-1236
Practice Address - Street 1:8416 XERXES AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55444-1469
Practice Address - Country:US
Practice Address - Phone:651-493-5102
Practice Address - Fax:651-666-1236
Is Sole Proprietor?:No
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst