Provider Demographics
NPI:1659820553
Name:CUNNING, CATHARINA JOHANNA (DED)
Entity Type:Individual
Prefix:DR
First Name:CATHARINA
Middle Name:JOHANNA
Last Name:CUNNING
Suffix:
Gender:F
Credentials:DED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:521 RIVER GATE RD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-6829
Mailing Address - Country:US
Mailing Address - Phone:814-876-0301
Mailing Address - Fax:
Practice Address - Street 1:521 RIVER GATE RD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-6829
Practice Address - Country:US
Practice Address - Phone:814-876-0301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005473101YP2500X
PA004670101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional