Healthcare Provider Details
I. General information
NPI: 1518326347
Provider Name (Legal Business Name): CINDY ENGLISH CRM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/22/2016
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 VIRGINIA AVE STE 201
NORTH BEND OR
97459-3444
US
IV. Provider business mailing address
PO BOX 1121
ROSEBURG OR
97470-0254
US
V. Phone/Fax
- Phone: 541-751-0357
- Fax: 541-564-9389
- Phone: 541-672-2691
- Fax: 541-564-9389
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175T00000X |
| Taxonomy | Peer Specialist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: