Individual
JOHNNY DARYEL CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
PO BOX 961, CHOUTEAU, OK 74337-0961
(918) 697-3823
(918) 476-0582
Mailing address
PO BOX 961, CHOUTEAU, OK 74337-0961
(918) 697-3823
(918) 476-0582
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
20325
OK
Other
Enumeration date
05/04/2007
Last updated
05/09/2024
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