Provider Demographics
NPI:1932372604
Name:CUNNINGHAM, DIANA PINSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:PINSON
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2007 N COLLINS BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-2658
Mailing Address - Country:US
Mailing Address - Phone:972-907-9129
Mailing Address - Fax:972-380-8262
Practice Address - Street 1:2007 N COLLINS BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-2658
Practice Address - Country:US
Practice Address - Phone:972-907-9129
Practice Address - Fax:972-380-8262
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22371103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00J88PMedicare PIN