Individual
MRS. GWENDOLYN LALISA CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3741 JACOB LOIS DR W, JACKSONVILLE, FL 32218-2972
(904) 627-6031
Mailing address
8020 MONCRIEF DINSMORE RD, JACKSONVILLE, FL 32219-3602
(904) 627-6031
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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