Healthcare Provider Details

I. General information

NPI: 1609181338
Provider Name (Legal Business Name): BARBARA ANN CENIGA ED.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 SW FRAZER AVE
PENDLETON OR
97801-2657
US

IV. Provider business mailing address

1708 SW FRAZER AVE
PENDLETON OR
97801-2657
US

V. Phone/Fax

Practice location:
  • Phone: 541-969-7160
  • Fax: 541-315-1334
Mailing address:
  • Phone: 541-969-7160
  • Fax: 541-315-1334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number050
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number052
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: