Provider Demographics
NPI:1720308984
Name:HOLLINS, CYNTHIA VIRGINIA (CMT)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:VIRGINIA
Last Name:HOLLINS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 KELLER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-2349
Mailing Address - Country:US
Mailing Address - Phone:415-336-3616
Mailing Address - Fax:
Practice Address - Street 1:5 KELLER ST STE 1
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-2349
Practice Address - Country:US
Practice Address - Phone:415-336-3616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor