Provider Demographics
NPI:1740981117
Name:CARRIG, CYNTHIA ZEMBA
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ZEMBA
Last Name:CARRIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 SURF SCOOTER DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32119-8385
Mailing Address - Country:US
Mailing Address - Phone:386-631-7281
Mailing Address - Fax:
Practice Address - Street 1:240 SURF SCOOTER DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32119-8385
Practice Address - Country:US
Practice Address - Phone:386-631-7281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-260701106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician