Provider Demographics
NPI:1811911282
Name:DIDONATO, CYNTHIA PATRICIA
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:PATRICIA
Last Name:DIDONATO
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 1:1415 GLADDING AVE
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004-2411
Mailing Address - Country:US
Mailing Address - Phone:440-964-9467
Mailing Address - Fax:
Practice Address - Street 1:54 S STATE ST
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-3445
Practice Address - Country:US
Practice Address - Phone:440-357-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI84651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical