Provider Demographics
NPI:1053207472
Name:LUGUTUAH, CINDY ALEXIS (MA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:ALEXIS
Last Name:LUGUTUAH
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 S ORCHARD ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-1961
Mailing Address - Country:US
Mailing Address - Phone:208-919-4692
Mailing Address - Fax:
Practice Address - Street 1:1111 S ORCHARD ST STE 102
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-1961
Practice Address - Country:US
Practice Address - Phone:208-919-4692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker