Provider Demographics
NPI:1437766714
Name:CUNNINGHAM, CATHERINE (OTR/L)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 KRISTIN CT SE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-8979
Mailing Address - Country:US
Mailing Address - Phone:571-228-8160
Mailing Address - Fax:
Practice Address - Street 1:40685 JOHN MOSBY HWY
Practice Address - Street 2:
Practice Address - City:ALDIE
Practice Address - State:VA
Practice Address - Zip Code:20105-2825
Practice Address - Country:US
Practice Address - Phone:571-228-8160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119003174225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist