Individual
CYNTHIA TANAKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
17585
AZ
101Y00000X
Counselor
5724
CO
101YM0800X
Mental Health Counselor
17585
AZ
101YM0800X
Mental Health Counselor
5724
CO
101YP2500X
Professional Counselor
17585
AZ
101YP2500X
Professional Counselor
Primary
5724
CO
Other
Enumeration date
02/07/2017
Last updated
04/01/2020
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