Individual
STACEY R CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP MSE CCC SLP
Contact information
Practice address
505 KELLER AVE S, AMERY, WI 54001
(715) 268-6900
(715) 268-6895
Mailing address
505 KELLER AVE S, AMERY, WI 54001
(715) 268-6900
(715) 268-6895
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2240154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
304K9CU
BCBS OF MN
—
05
—
42793800
—
WI
01
—
4600981
MEDICA INS
—
01
—
HP48076
HEALTH PARTNERS
—
Enumeration date
12/15/2006
Last updated
07/08/2007
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