Provider Demographics
NPI:1669710430
Name:ROLLINS, CINDY ALEXANDRA TUTTLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:ALEXANDRA TUTTLE
Last Name:ROLLINS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 W IRON SPRINGS RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-3313
Mailing Address - Country:US
Mailing Address - Phone:928-458-5817
Mailing Address - Fax:
Practice Address - Street 1:1680 W IRON SPRINGS RD
Practice Address - Street 2:SUITE 103
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-3313
Practice Address - Country:US
Practice Address - Phone:928-458-5817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4220103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical