Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 7360 | NC |
NPI | 1003059551 |
---|---|
Provider Name | Mrs. Holly Cunningham |
First Address | Wilmington, NC 28403-1403 |
Second Address | Wilmington, NC 28403-1403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2009 |
Last Update Date | 14/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7360 | NC BOARD OF LICENSED PROFESSIONAL COUNSELORS (01) | NC |