Provider Demographics
NPI:1912045956
Name:WING, CYNTHIA DEE (MA, BCBA)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:DEE
Last Name:WING
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1390 S DESERT CREST DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-1001
Mailing Address - Country:US
Mailing Address - Phone:520-624-4240
Mailing Address - Fax:520-629-0737
Practice Address - Street 1:1390 S DESERT CREST DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85713-1001
Practice Address - Country:US
Practice Address - Phone:520-624-4240
Practice Address - Fax:520-629-0737
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1-06-3200103TB0200X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities