Provider Demographics
NPI:1477667715
Name:CUNNINGHAM, PATRICIA A (CCC A SLP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:CCC A SLP
Other - Prefix:MRS
Other - First Name:PATRICIA
Other - Middle Name:A
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CCC A SLP
Mailing Address - Street 1:1698 MEADOWOOD LN
Mailing Address - Street 2:#150
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502
Mailing Address - Country:US
Mailing Address - Phone:775-825-6012
Mailing Address - Fax:775-825-3331
Practice Address - Street 1:1698 MEADOWOOD LN
Practice Address - Street 2:#150
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502
Practice Address - Country:US
Practice Address - Phone:775-825-6012
Practice Address - Fax:775-825-3331
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA053231H00000X, 237700000X
NVSP223235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist