Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 32944 | TX |
N | 103T00000X | Psychologist | 32944 | TX |
N | 103TH0100X | Health Service | 32944 | TX |
NPI | 1467575688 |
---|---|
Provider Name | Dr. Mary V Cunningham |
First Address | Austin, TX 78756-3207 |
Second Address | Austin, TX 78759-8598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 08/07/2007 |