Provider Demographics
NPI:1124265251
Name:WITMAN, CYNTHIA (MDIV, NBCC, QCDC1)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:WITMAN
Suffix:
Gender:F
Credentials:MDIV, NBCC, QCDC1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 W. ALDER
Mailing Address - Street 2:#316
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2863
Mailing Address - Country:US
Mailing Address - Phone:509-525-7486
Mailing Address - Fax:509-525-7486
Practice Address - Street 1:5 W. ALDER
Practice Address - Street 2:#316
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2863
Practice Address - Country:US
Practice Address - Phone:509-525-7486
Practice Address - Fax:509-525-7486
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAC830003041101YA0400X
WA601444411101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health