Kellie Cunningham
Behavior Technician in Lakewood, CA. Individual provider (NPI-1).
NPI number1659039733
StatusActive
Last updated in NPPESNov 14, 2023
Details
- NPI
- 1659039733
- Entity type
- Individual (NPI-1)
- Name
- Kellie Cunningham
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 6, 2021
- Certification date
- Oct 12, 2023
- Last updated
- Nov 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
5834 Adenmoor AveLakewood, CA 90713-1002
Phone 303-989-8169
Mailing address
5834 Adenmoor AveLakewood, CA 90713-1002
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