Doctor Name: | DIANE K. DELEGARD |
NPI Number: | 1093746729 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | 3022-125 |
Business Practice Address: | 2321 Stout Rd Menomonie, WI - 547517003 |
Business Phone Number: | 7152355531 |
Business Fax Number: | 7152337645 |
Mailing Address: | 2321 Stout Rd, MENOMONIE |
State: | WI |
Postal Code: | 547517003 |
Phone Number: | 7152355531 |
Fax Number: | 7152337645 |
NPI Enumeration Date: | 07/05/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3022-125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |