Individual
JOSEPH CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, MS
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
LA
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750754727
—
LA
Enumeration date
01/24/2021
Last updated
07/19/2022
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