Individual
MS. CHARLA KAY CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT RDT
Contact information
Practice address
7824 SE 13TH AVE, PORTLAND, OR 97202
(503) 735-5870
Mailing address
1925 GLENMORRIE DR, LAKE OSWEGO, OR 97034-6341
(503) 635-3401
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
T0524
OR
Other
Enumeration date
03/07/2007
Last updated
06/05/2013
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