Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 2360 | LA |
NPI | 1003254749 |
---|---|
Provider Name | Darlene Cunningham |
First Address | Baton Rouge, LA 70808-3229 |
Second Address | Baton Rouge, LA 70808-3229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2013 |
Last Update Date | 04/06/2013 |