Provider Demographics
NPI:1598101610
Name:CUNNINGHAM, BARBARA LETICIA
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:LETICIA
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:LETICIA
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1409 HELEN BELLE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-2806
Mailing Address - Country:US
Mailing Address - Phone:702-872-5382
Mailing Address - Fax:702-872-5381
Practice Address - Street 1:1200 HARRIS SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89124-9215
Practice Address - Country:US
Practice Address - Phone:702-872-5382
Practice Address - Fax:702-872-5381
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)