Healthcare Provider Details

I. General information

NPI: 1780701805
Provider Name (Legal Business Name): CYNTHIA M. FUNES PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 E MCDOWELL RD
PHOENIX AZ
85006-2506
US

IV. Provider business mailing address

222 W THOMAS RD STE 315
PHOENIX AZ
85013-4422
US

V. Phone/Fax

Practice location:
  • Phone: 844-242-4664
  • Fax:
Mailing address:
  • Phone: 602-406-3671
  • Fax: 602-406-6115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY-005032
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: