Individual
JACK CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1221 KILAUEA AVE, HILO, HI 96720-4271
(808) 607-0117
Mailing address
15-2662 PAHOA VILLAGE RD # 306-105, PAHOA, HI 96778-7730
(510) 695-4304
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
677
HI
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
12/01/2015
Last updated
09/07/2023
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