Individual
CAYLLA LEIGH CUNNINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
94 W MAIN ST STE 200, BAY SHORE, NY 11706-8365
(631) 252-2820
Mailing address
183 WASHINGTON AVE, EAST PATCHOGUE, NY 11772-2756
(631) 487-8765
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
110743
NY
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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