Provider Demographics
NPI:1184133407
Name:WITT, CINDY (CRPS)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:WITT
Suffix:
Gender:F
Credentials:CRPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8608 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-5120
Mailing Address - Country:US
Mailing Address - Phone:904-610-0788
Mailing Address - Fax:
Practice Address - Street 1:804 3RD ST STE AB
Practice Address - Street 2:
Practice Address - City:NEPTUNE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32266-5040
Practice Address - Country:US
Practice Address - Phone:904-610-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-29
Last Update Date:2017-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCRPS100116175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist