Provider Demographics
NPI:1639772304
Name:CUNNINGHAM, MELODY (CLC)
Entity Type:Individual
Prefix:MS
First Name:MELODY
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 ESSEX STREET
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188
Mailing Address - Country:US
Mailing Address - Phone:617-955-5083
Mailing Address - Fax:
Practice Address - Street 1:7 ESSEX STREET
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02188
Practice Address - Country:US
Practice Address - Phone:617-955-5083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAALPP-310378OtherCERTIFIED LACTATION COUNSELOR