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Individual
MR. BRANDON MARK CUNNINGHAM
Active
Individual
MR. BRANDON MARK CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LSCSW, CRADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
11808
MO
1041C0700X
Clinical Social Worker
Primary
05584
KS
1041C0700X
Clinical Social Worker
2021036486
MO
Other
Enumeration date
11/17/2021
Last updated
09/25/2024
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