Basic Information
| Provider Information | |||||||||
| NPI: | 1760711303 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CUNNINGHAM | ||||||||
| FirstName: | BATRIAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 541 MAIN ST | ||||||||
| Address2: | SUITE 317 STETSON BLDG | ||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021901868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085804691 | ||||||||
| FaxNumber: | 5085885751 | ||||||||
| Practice Location | |||||||||
| Address1: | 541 MAIN ST | ||||||||
| Address2: | SUITE 317 STETSON BLDG | ||||||||
| City: | WEYMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021901868 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7813317866 | ||||||||
| FaxNumber: | 5085885751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2009 | ||||||||
| LastUpdateDate: | 12/10/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.