Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1041C0700X | Clinical Social Worker | 17261 | MD |
Y | 1041C0700X | Clinical Social Worker | LC50079628 | DC |
NPI | 1003231499 |
---|---|
Provider Name | Mr. Schuyler Cunningham |
First Address | Washington, DC 20006-1602 |
Second Address | Washington, DC 20006-1602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2014 |
Last Update Date | 21/02/2014 |