Organization
PHYLLIS MCCOLISTER-CUNNINGHAM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHYLLIS MCCOLISTER-CUNNINGHAM (CEO & OWNER)
(772) 448-4189
Entity
Organization
Contact information
Practice address
900 VIRGINIA AVE STE 7, FORT PIERCE, FL 34982-5882
(772) 448-4189
(772) 245-4259
Mailing address
900 VIRGINIA AVE STE 7, FORT PIERCE, FL 34982-5882
(772) 448-4189
(772) 245-4259
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MH14456
FL
Other
Enumeration date
05/02/2017
Last updated
12/05/2023
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