Provider Demographics
NPI:1144365339
Name:MAYNARD, CYNTHIA INEZ (LMFT)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:INEZ
Last Name:MAYNARD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RESOURCE MANAGEMENT
Mailing Address - Street 2:1300 HOPPE BLVD., SUITE 1
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:1726 NORTH GREEN AVENUE
Practice Address - Street 2:STRONG FAMILY DEVELOPMENT-OUTPATIENT SERVICES PURCELL
Practice Address - City:PURCELL
Practice Address - State:OK
Practice Address - Zip Code:73080
Practice Address - Country:US
Practice Address - Phone:405-767-8940
Practice Address - Fax:580-421-8748
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK868106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist