Provider Demographics
NPI:1013311042
Name:TEJEDA, CINTHYA IDALGISA
Entity Type:Individual
Prefix:
First Name:CINTHYA
Middle Name:IDALGISA
Last Name:TEJEDA
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 1:71 GREENWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01841-4624
Mailing Address - Country:US
Mailing Address - Phone:978-495-6100
Mailing Address - Fax:
Practice Address - Street 1:71 GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-4624
Practice Address - Country:US
Practice Address - Phone:978-495-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-20
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst