Provider Demographics
NPI:1356773469
Name:CUNNINGHAM, MICHELLE RHYNE
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:RHYNE
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:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:STANLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28164-0413
Mailing Address - Country:US
Mailing Address - Phone:704-689-4025
Mailing Address - Fax:
Practice Address - Street 1:824 GUM BRANCH RD STE W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-6269
Practice Address - Country:US
Practice Address - Phone:252-672-8680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-31
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist