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General NPI Number Information
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NPI Number | 1184872590
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Entity Type | Individual
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Provider Name | KATHY J CUNNINGHAM
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Gender | Female
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 3243 E WARM SPRINGS RD SUITE 104
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City | LAS VEGAS
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State | NV
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Zip | 89120-3185
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Country | US
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Telephone | 702-813-1127
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Fax |
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Provider Business Mailing Address
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Address Line | 513 WINDING OAK CT
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City | HENDERSON
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State | NV
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Zip | 89012-4578
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Country | US
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Telephone | 702-813-1127
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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 |
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License Number State | NV
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