Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 0701001629 | VA |
NPI | 1073687737 |
---|---|
Provider Name | Dr. Maureen Mala Cunningham |
First Address | Charlottesville, VA 22903-1533 |
Second Address | Charlottesville, VA 22903-1533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 08/07/2007 |