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General NPI Number Information
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NPI Number | 1386128502
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Entity Type | Individual
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Provider Name | COURTNEY CUNNINGHAM OTR
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Gender | Female
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Dates
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Enumeration Date | 09/24/2018
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 875 RETREAT DR
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City | NAPLES
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State | FL
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Zip | 34110-7927
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Country | US
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Telephone | 239-431-2165
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Fax | 239-431-2169
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Provider Business Mailing Address
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Address Line | 875 RETREAT DR
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City | NAPLES
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State | FL
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Zip | 34110-7927
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Country | US
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Telephone | 239-431-2165
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Fax | 239-431-2169
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OT14742
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License Number State | FL
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