Individual
MS. KIMBERLE MARY CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC LMFT LAC
Contact information
Practice address
641 OLIVE ST, SHREVEPORT, LA 71104-2209
(318) 841-5657
(318) 584-7140
Mailing address
908 ERIE STREET, SHREVEPORT, LA 71106
(318) 840-9399
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1119
LA
101YP2500X
Professional Counselor
Primary
2501
LA
106H00000X
Marriage & Family Therapist
676
LA
Other
Enumeration date
02/16/2007
Last updated
03/01/2019
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