Provider Demographics
NPI:1194929521
Name:FREEMAN-THOMPSON, CYNTHIA DIANE (MA, MS, MFTI)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:DIANE
Last Name:FREEMAN-THOMPSON
Suffix:
Gender:F
Credentials:MA, MS, MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 E 1ST ST # 1271
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4903
Mailing Address - Country:US
Mailing Address - Phone:818-692-0221
Mailing Address - Fax:
Practice Address - Street 1:15339 SATICOY ST
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-3345
Practice Address - Country:US
Practice Address - Phone:818-266-8621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist