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General NPI Number Information
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NPI Number | 1538657556
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Entity Type | Individual
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Provider Name | THEA ANDREA CIMA B.S, TCADC
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Gender | Female
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 3110 CUMBERLAND FALLS HWY
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City | CORBIN
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State | KY
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Zip | 40701-8681
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Country | US
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Telephone | 606-523-9386
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Fax | 606-523-9307
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Provider Business Mailing Address
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Address Line | 1764 N KY 233
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City | GRAY
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State | KY
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Zip | 40734-6752
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Country | US
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Telephone | 606-521-2611
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 240587
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License Number State | KY
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