Doctor Name: | MS. THERESA BOYLE CUNNINGHAM |
NPI Number: | 1295897890 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | SP 13791 |
Business Practice Address: | 13652 Cantara St Panorama City, CA - 914025423 |
Business Phone Number: | 8183752548 |
Business Fax Number: | 8183754430 |
Mailing Address: | 13652 Cantara St, PANORAMA CITY |
State: | CA |
Postal Code: | 914025423 |
Phone Number: | 8183752548 |
Fax Number: | 8183754430 |
NPI Enumeration Date: | 12/14/2006 |
NPI Last Update Date: | 09/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP 13791 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |