Individual
BENJAMIN A CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ED. S.
Contact information
Practice address
1200 S CLINTON ST, FORT WAYNE, IN 46802-3504
(260) 467-1110
Mailing address
1200 S CLINTON ST, FORT WAYNE, IN 46802-3504
(260) 467-1149
(260) 467-1188
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1620132
IN
Other
Enumeration date
02/05/2019
Last updated
01/24/2024
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