Healthcare Provider Details
I. General information
NPI: 1679595623
Provider Name (Legal Business Name): CYNTHIA L HORVATH SR. CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/25/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3165 MCKELVEY RD SUITE 200
BRIDGETON MO
63044-2550
US
IV. Provider business mailing address
1430 OLIVE ST SUITE 200
SAINT LOUIS MO
63103-2303
US
V. Phone/Fax
- Phone: 314-206-3974
- Fax: 314-206-3992
- Phone: 314-206-3974
- Fax: 314-206-3992
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: