Provider Demographics
NPI:1215292644
Name:STRONG, CYNTHIA DENISE (MHA, PTA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DENISE
Last Name:STRONG
Suffix:
Gender:F
Credentials:MHA, PTA
Other - Prefix:MS
Other - First Name:CYNTHIA
Other - Middle Name:DENISE
Other - Last Name:STRONG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHA, PTA
Mailing Address - Street 1:341 WINN WAY
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030
Mailing Address - Country:US
Mailing Address - Phone:404-445-3762
Mailing Address - Fax:
Practice Address - Street 1:341 WINN WAY
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2120
Practice Address - Country:US
Practice Address - Phone:404-445-3762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA000672164W00000X
GAPTA00672225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No164W00000XNursing Service ProvidersLicensed Practical Nurse