Provider Demographics
NPI:1194543256
Name:LUNA, CYNTHIA MARGARITA
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:MARGARITA
Last Name:LUNA
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 1:3057 CHADWICK PL
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-0211
Mailing Address - Country:US
Mailing Address - Phone:832-454-2510
Mailing Address - Fax:
Practice Address - Street 1:3057 CHADWICK PL
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-0211
Practice Address - Country:US
Practice Address - Phone:832-454-2510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90435101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional