Provider Demographics
NPI:1073554556
Name:BRUNO, DIANNA (PSYD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:
Last Name:BRUNO
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1725
Mailing Address - Country:US
Mailing Address - Phone:716-285-1904
Mailing Address - Fax:
Practice Address - Street 1:419 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1725
Practice Address - Country:US
Practice Address - Phone:716-285-1904
Practice Address - Fax:716-284-8262
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017707-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical