Basic Information
| Provider Information | |||||||||
| NPI: | 1780701805 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FUNES | ||||||||
| FirstName: | CYNTHIA | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 W THOMAS RD | ||||||||
| Address2: | STE 315 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850134422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024063671 | ||||||||
| FaxNumber: | 6024066115 | ||||||||
| Practice Location | |||||||||
| Address1: | 755 E MCDOWELL RD | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850062506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8442424664 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2007 | ||||||||
| LastUpdateDate: | 08/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225400000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | 103G00000X | PSY-005032 | AZ | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist |
No ID Information.