Provider Demographics
NPI:1326876202
Name:BAINBRIDGE, CYNTHIA JOY (PHD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:JOY
Last Name:BAINBRIDGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 GRAND AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403-6421
Mailing Address - Country:US
Mailing Address - Phone:920-392-2968
Mailing Address - Fax:
Practice Address - Street 1:4005 COMMUNITY CENTER DR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:WI
Practice Address - Zip Code:54476-4139
Practice Address - Country:US
Practice Address - Phone:715-241-5400
Practice Address - Fax:715-241-5424
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57-2589103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist