Provider Demographics
NPI:1457616856
Name:CULBREATH, CYNTHIA MARIE (MA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARIE
Last Name:CULBREATH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:MARIE
Other - Last Name:TRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3201 34TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33711-3828
Mailing Address - Country:US
Mailing Address - Phone:727-455-7451
Mailing Address - Fax:
Practice Address - Street 1:3201 34TH ST S
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33711-3828
Practice Address - Country:US
Practice Address - Phone:727-455-7451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMHI7163101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health