Provider Demographics
NPI:1922252535
Name:CUNNINGHAM TIGUE, ANN M (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:M
Last Name:CUNNINGHAM TIGUE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 ADELPHI RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-3511
Mailing Address - Country:US
Mailing Address - Phone:516-221-6997
Mailing Address - Fax:
Practice Address - Street 1:1720 ADELPHI RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-3511
Practice Address - Country:US
Practice Address - Phone:516-221-6997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8054235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist