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Individual

JENNY SUE CUNNINGHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCMHC

Contact information

Practice address
20 W CANAL ST, SUITE C2, WINOOSKI, VT 05404-2131
(802) 654-7600
(802) 654-7601
Mailing address
20 W CANAL ST, SUITE C2, WINOOSKI, VT 05404-2131
(802) 654-7600
(802) 654-7601

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000465
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1008198
VT
01
58344
PROVIDER NUMBER
VT
Enumeration date
12/06/2006
Last updated
07/09/2007
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