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Individual

KELSEY CUNNINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
EIS, LBSW

Contact information

Practice address
1709 10TH ST, WICHITA FALLS, TX 76301-5010
(940) 696-6200
(940) 696-6210
Mailing address
9996 COUNTY LINE RD N, ELECTRA, TX 76360-3606
(806) 731-2290

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
59451
TX
174400000X
Specialist
Primary
15-0037
TX

Other

Enumeration date
02/08/2018
Last updated
02/08/2018
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