Provider Demographics
NPI:1811336381
Name:GUZMAN, CYNTHIA EILEEN (PHD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:EILEEN
Last Name:GUZMAN
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 1:85 WEST HIGHWAY 22
Mailing Address - Street 2:
Mailing Address - City:SANTO DOMINGO
Mailing Address - State:NM
Mailing Address - Zip Code:87052
Mailing Address - Country:US
Mailing Address - Phone:505-465-3068
Mailing Address - Fax:505-465-1178
Practice Address - Street 1:85 WEST HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:SANTO DOMINGO
Practice Address - State:NM
Practice Address - Zip Code:87052
Practice Address - Country:US
Practice Address - Phone:505-465-3068
Practice Address - Fax:505-465-1178
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1276103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling