Doctor Name: | CYNTHIA (CINDY) DAWN WILLARD |
NPI Number: | 1104282151 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCP |
License Number: | 2074546 |
Business Practice Address: | 2701 17th St Rock Island, IL - 612015351 |
Business Phone Number: | 3097797500 |
Business Fax Number: | 3097797505 |
Mailing Address: | 2701 17th St, ROCK ISLAND |
State: | IL |
Postal Code: | 612015351 |
Phone Number: | 3097797500 |
Fax Number: | 3097797505 |
NPI Enumeration Date: | 01/06/2016 |
NPI Last Update Date: | 01/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YS0200X |
License Number: | 2074546 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | School |
Taxonomy Definition: |