Provider Demographics
NPI:1356103899
Name:CUNNINGHAM, BRYTTNEY
Entity type:Individual
Prefix:
First Name:BRYTTNEY
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 NORTH ST STE 1A
Mailing Address - Street 2:
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-1666
Mailing Address - Country:US
Mailing Address - Phone:508-688-4695
Mailing Address - Fax:508-242-5318
Practice Address - Street 1:70 NORTH ST STE 1A
Practice Address - Street 2:
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-1666
Practice Address - Country:US
Practice Address - Phone:508-688-4695
Practice Address - Fax:508-242-5318
Is Sole Proprietor?:No
Enumeration Date:2024-01-30
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10000594103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst