Provider Demographics
NPI:1336361880
Name:SPENCER, CYNTHIA K (MSED)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:K
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:S
Other - Last Name:HUGHS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7304 CAVE HOLW
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-8243
Mailing Address - Country:US
Mailing Address - Phone:505-400-9846
Mailing Address - Fax:
Practice Address - Street 1:3595 RANCH ROAD 620 S
Practice Address - Street 2:
Practice Address - City:BEE CAVE
Practice Address - State:TX
Practice Address - Zip Code:78738
Practice Address - Country:US
Practice Address - Phone:512-772-4042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2019-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0095211101YM0800X
TX2677103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health