Doctor Name: | MS. CYDNEY BOUBON |
NPI Number: | 1386801165 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT, CNMT |
License Number: | 12560 |
Business Practice Address: | 1126 E Monument St Colorado Springs, CO - 809032869 |
Business Phone Number: | 7194750501 |
Business Fax Number: | |
Mailing Address: | 330 E Costilla St, Pmb#31 COLORADO SPRINGS |
State: | CO |
Postal Code: | 809032106 |
Phone Number: | 7194750501 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2008 |
NPI Last Update Date: | 05/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 12560 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |