Individual
BETHANY I CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
127 VILLAGE RD UNIT B, SHALLOTTE, NC 28470-4439
(910) 754-3484
(910) 754-3485
Mailing address
PO BOX 1288, LUMBERTON, NC 28359-1288
(910) 671-9629
(910) 671-9630
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7211405
—
NC
Enumeration date
11/17/2021
Last updated
11/17/2021
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