Individual
GRACE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 BACHELOR GULCH ROAD, AVON, CO 81620
(516) 477-6569
Mailing address
15 BACHELOR GULCH ROAD, AVON, CO 81620
(516) 477-6569
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LSW0009923531
CO
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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