Provider Demographics
NPI:1932616240
Name:CUNNINGHAM, AISLINN (RBT)
Entity Type:Individual
Prefix:
First Name:AISLINN
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19120 HOLBERTON LN
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20833-2634
Mailing Address - Country:US
Mailing Address - Phone:240-506-7600
Mailing Address - Fax:
Practice Address - Street 1:19120 HOLBERTON LN
Practice Address - Street 2:
Practice Address - City:BROOKEVILLE
Practice Address - State:MD
Practice Address - Zip Code:20833-2634
Practice Address - Country:US
Practice Address - Phone:240-506-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRBT-16-25761106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician