Individual
DEVANTE JORDAN CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5 COLUMBUS CIR, NEW YORK, NY 10019-1412
(804) 892-0125
Mailing address
5 COLUMBUS CIR, NEW YORK, NY 10019-1412
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
05/10/2022
Last updated
05/10/2022
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