Provider Demographics
NPI:1154979482
Name:HOLCOMB, CYNTHIA D
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:D
Last Name:HOLCOMB
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 1:18115 PALM BEACH DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-4048
Mailing Address - Country:US
Mailing Address - Phone:305-796-3336
Mailing Address - Fax:
Practice Address - Street 1:18115 PALM BEACH DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-4048
Practice Address - Country:US
Practice Address - Phone:305-796-3336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral