Provider Demographics
NPI:1881763258
Name:CORDEIRO, IRNA GAY
Entity type:Individual
Prefix:MS
First Name:IRNA
Middle Name:GAY
Last Name:CORDEIRO
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:IRNA
Other - Middle Name:GAY
Other - Last Name:PAXSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:USAG SCHWEINFURT
Mailing Address - Street 2:CMR 457 BOX 689
Mailing Address - City:APO
Mailing Address - State:APO
Mailing Address - Zip Code:09033
Mailing Address - Country:DE
Mailing Address - Phone:490972-196-1710
Mailing Address - Fax:490872-196-6633
Practice Address - Street 1:USAG SCHWEINFURT
Practice Address - Street 2:CMR 457 BOX 689
Practice Address - City:APO
Practice Address - State:APO
Practice Address - Zip Code:09033
Practice Address - Country:DE
Practice Address - Phone:490972-196-1710
Practice Address - Fax:490872-196-6633
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3101101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)