Individual
LILLIE KORAN CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
6601 ZEBULON RD, MACON, GA 31220-7606
(478) 477-3383
Mailing address
521 ANDERSON AVE, FORT VALLEY, GA 31030-4140
(478) 477-3383
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001354
GA
Other
Enumeration date
03/13/2013
Last updated
10/07/2014
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