Provider Demographics
NPI:1902347909
Name:HANNIGAN, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:HANNIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8451
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76714-8451
Mailing Address - Country:US
Mailing Address - Phone:254-235-6542
Mailing Address - Fax:254-235-6254
Practice Address - Street 1:2121 W WACO DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76707-3480
Practice Address - Country:US
Practice Address - Phone:254-235-6542
Practice Address - Fax:254-235-6254
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX73820101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional