Provider Demographics
NPI:1669798013
Name:CUNNINGHAM, CINDY RUTH (MA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:RUTH
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:CINDY
Other - Middle Name:RUTH
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2328 N DONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-5942
Mailing Address - Country:US
Mailing Address - Phone:405-706-2084
Mailing Address - Fax:
Practice Address - Street 1:2328 N DONALD AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-5942
Practice Address - Country:US
Practice Address - Phone:405-706-2084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
OKLPC CAND101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No251B00000XAgenciesCase Management