Doctor Name: | JEANETTE MARIE DIEKMAN |
NPI Number: | 1316921083 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, LPC |
License Number: | 3447 |
Business Practice Address: | 484 Williamson Rd Suite 105/e Mooresville, NC - 281179110 |
Business Phone Number: | 7045001208 |
Business Fax Number: | |
Mailing Address: | Po Box 3993, MOORESVILLE |
State: | NC |
Postal Code: | 281173993 |
Phone Number: | 7045001208 |
Fax Number: | 7046960434 |
NPI Enumeration Date: | 12/05/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 3447 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |