Most Relevant Information
Provider Data
| NPI Number: | 1003668799 |
| Provider Name: | EBONEE ROSE CUNNINGHAM |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/04/2024 |
| Last Updated: | 04/04/2024 |
Provider Practice Location
901 CALEDONIA ST
LA CROSSE
WI
546032616
Practice Location Phone/Fax
| Phone: | 6087854100 |
| Fax: |
Provider Mailing Location
1509 SOUTHCROSS DR W
BURNSVILLE
MN
553066945
Provider Mailing Phone/Fax
| Phone: | 9527465350 |
| Fax: |