Provider Demographics
NPI:1194744730
Name:MAGUIRE, CYNTHIA N (PSYD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:N
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:N
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:531 WASHINGTON ST
Mailing Address - Street 2:SUITE 2501
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601
Mailing Address - Country:US
Mailing Address - Phone:315-882-7274
Mailing Address - Fax:315-601-9988
Practice Address - Street 1:531 WASHINGTON ST
Practice Address - Street 2:SUITE 2501
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601
Practice Address - Country:US
Practice Address - Phone:315-882-7274
Practice Address - Fax:315-601-9988
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015958103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical