Individual
SPARKLE LASTAR CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
700 19TH ST S, BIRMINGHAM, AL 35233-1927
(205) 933-8101
Mailing address
2910 ALLISON BONNETT MEMORIAL DR STE 106, HUEYTOWN, AL 35023-1877
(205) 201-0376
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3775C
AL
Other
Enumeration date
05/24/2017
Last updated
10/14/2022
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