Healthcare Provider Details

I. General information

NPI: 1669954640
Provider Name (Legal Business Name): CYNTHIA CHRISTINE TOMS MA, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 7TH AVE SE STE 203
CEDAR RAPIDS IA
52401-2007
US

IV. Provider business mailing address

317 7TH AVE SE STE 203
CEDAR RAPIDS IA
52401-2007
US

V. Phone/Fax

Practice location:
  • Phone: 319-247-4873
  • Fax: 319-247-4877
Mailing address:
  • Phone: 319-247-4873
  • Fax: 319-247-4877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number01035
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: