Provider Demographics
NPI:1780898197
Name:COTTLE, CINDY CATHLEEN (PHD)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:CATHLEEN
Last Name:COTTLE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 MCNEELY DR
Mailing Address - Street 2:STE 101
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-7623
Mailing Address - Country:US
Mailing Address - Phone:919-827-2148
Mailing Address - Fax:919-882-1685
Practice Address - Street 1:5500 MCNEELY DR
Practice Address - Street 2:STE 101
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-7623
Practice Address - Country:US
Practice Address - Phone:919-827-2148
Practice Address - Fax:919-882-1685
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3061103TC0700X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic