Provider Demographics
NPI:1073995890
Name:CUNNINGHAM, BRENDA (MS, ATR)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MS, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 LINCOLN WAY W
Mailing Address - Street 2:
Mailing Address - City:NEW OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:17350-1003
Mailing Address - Country:US
Mailing Address - Phone:717-624-4461
Mailing Address - Fax:717-624-3011
Practice Address - Street 1:343 LINCOLN WAY W
Practice Address - Street 2:
Practice Address - City:NEW OXFORD
Practice Address - State:PA
Practice Address - Zip Code:17350-1003
Practice Address - Country:US
Practice Address - Phone:717-624-4461
Practice Address - Fax:717-624-3011
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2015-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist