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General NPI Number Information
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NPI Number | 1134473424
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Entity Type | Individual
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Provider Name | CYNTHIA WADYSZ LPC, PC, C.HT.
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Gender | Female
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 5758 MAIN ST SUITE 3
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City | SYLVANIA
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State | OH
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Zip | 43560-1990
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Country | US
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Telephone | 734-625-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 14765 IDA WEST RD
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City | PETERSBURG
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State | MI
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Zip | 49270-9506
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Country | US
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Telephone | 734-625-0011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | C.1100230
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 6401013381
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License Number State | MI
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