Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 000020 | CT |
NPI | 1003831520 |
---|---|
Provider Name | Mrs. Carolyn Cunningham |
First Address | Danbury, CT 06810-5648 |
Second Address | Danbury, CT 06810-5648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2006 |
Last Update Date | 08/07/2007 |