Individual
LISA CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Contact information
Practice address
608 SHELLEY LN, WEXFORD, PA 15090-1516
(304) 650-6094
Mailing address
608 SHELLEY LN, WEXFORD, PA 15090-1516
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL013874
PA
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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