Individual
DESERI ALICIA CUNNINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LP
Contact information
Practice address
1350 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4376
(417) 761-5850
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5011
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2014022296
MO
103TC0700X
Clinical Psychologist
Primary
2016035950
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490014993
—
MO
Enumeration date
07/03/2014
Last updated
11/05/2025
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