Doctor Name: | BILL DAVID CUNIGAN |
NPI Number: | 1023480480 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 072525 |
Business Practice Address: | 1200 Valley West Dr Suite 306 West Des Moines, IA - 502661908 |
Business Phone Number: | 5152671340 |
Business Fax Number: | 5152671355 |
Mailing Address: | 1200 Valley West Dr, Suite 306 WEST DES MOINES |
State: | IA |
Postal Code: | 502661908 |
Phone Number: | 5152671340 |
Fax Number: | 5152671355 |
NPI Enumeration Date: | 10/26/2015 |
NPI Last Update Date: | 10/26/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 072525 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |