Provider Demographics
NPI:1558319442
Name:CUNNINGHAM, MARAYEH (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARAYEH
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1990
Mailing Address - Street 2:
Mailing Address - City:TUBAC
Mailing Address - State:AZ
Mailing Address - Zip Code:85646-1990
Mailing Address - Country:US
Mailing Address - Phone:520-398-3970
Mailing Address - Fax:520-398-2944
Practice Address - Street 1:26 TUBAC ROAD
Practice Address - Street 2:SUITE B
Practice Address - City:TUBAC
Practice Address - State:AZ
Practice Address - Zip Code:85646-1990
Practice Address - Country:US
Practice Address - Phone:520-398-3970
Practice Address - Fax:520-398-2944
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3784103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical