Individual
BLAKELY RAE CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
14864 COUNTY ROAD 433, TYLER, TX 75706-3206
(903) 636-7994
Mailing address
14864 COUNTY ROAD 433, TYLER, TX 75706-3206
(903) 830-2595
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
TX
106E00000X
Assistant Behavior Analyst
—
TX
106S00000X
Behavior Technician
—
TX
Other
Enumeration date
10/13/2021
Last updated
06/29/2024
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