Individual
MRS. CYNTHIA MARIE ELIZONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2550 UNIVERSITY AVE W, SUITE 229N, SAINT PAUL, MN 55114-1052
(651) 645-3115
(651) 645-2752
Mailing address
1307 GOODRICH AVE, SAINT PAUL, MN 55105-2708
(651) 695-1022
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
00299
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41-1576550
PRACTICE FED TAX ID#
—
Enumeration date
09/25/2006
Last updated
08/17/2009
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