Provider Demographics
NPI:1730309550
Name:GUNNINGS, SONYA RENITA (PHD)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:RENITA
Last Name:GUNNINGS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MRS
Other - First Name:SONYA
Other - Middle Name:RENITA
Other - Last Name:GUNNINGS MOTON HUSBAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5031 PARK LAKE ROAD
Mailing Address - Street 2:MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS PC
Mailing Address - City:EAST LANSING
Mailing Address - State:MA
Mailing Address - Zip Code:48823-3835
Mailing Address - Country:US
Mailing Address - Phone:517-332-0811
Mailing Address - Fax:517-332-4452
Practice Address - Street 1:5031 PARK LAKE ROAD
Practice Address - Street 2:MERIDIAN PROFESSIONAL PSYCHOLOGICAL CONSULTANTS PC
Practice Address - City:EAST LANSING
Practice Address - State:MA
Practice Address - Zip Code:48823-3835
Practice Address - Country:US
Practice Address - Phone:517-332-0811
Practice Address - Fax:517-332-4452
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005912103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical