Provider Demographics
NPI:1346786233
Name:DIEKE, SUNDAY (LMFT)
Entity Type:Individual
Prefix:
First Name:SUNDAY
Middle Name:
Last Name:DIEKE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 CALCITE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76131-3398
Mailing Address - Country:US
Mailing Address - Phone:817-372-3697
Mailing Address - Fax:
Practice Address - Street 1:10000 CALCITE DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76131-3398
Practice Address - Country:US
Practice Address - Phone:817-372-3697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202060106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist