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NPI 1407192511

NPI 1407192511 : CYNTHIA CHESTNUT PH.D., LMFT : MIDDLETOWN, DE

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General NPI Number Information
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    NPI Number           |    1407192511
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    Entity Type          |    Individual 
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    Provider Name        |    CYNTHIA CHESTNUT PH.D., LMFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/17/2012
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    Last Update Date     |    05/02/2013
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Provider Practice Location Address
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    Address Line         |    4 HOGAN CIR 
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    City                 |    MIDDLETOWN
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    State                |    DE
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    Zip                  |    19709-9367
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    Country              |    US
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    Telephone            |    302-373-7312
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4 HOGAN CIR 
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    City                 |    MIDDLETOWN
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    State                |    DE
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    Zip                  |    19709-9367
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    Country              |    US
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    Telephone            |    302-373-7312
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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        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    FT-0000025
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    License Number State |    DE
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