| Ingrid Diederen Phd Pa | |
|
172 Asheland Ave Suite D Asheville NC 28801-4005 | |
| (828) 253-1445 | |
| (828) 253-1456 |
| Full Name | Ingrid Diederen Phd Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 172 Asheland Ave, Asheville, North Carolina |
| Authorized Official Name and Position | Ingrid Mary Diederen (PRESIDENT) |
| Authorized Official Contact | 8282531445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ingrid Diederen Phd Pa 172 Asheland Ave Suite D Asheville NC 28801-0172 Ph: () - | Ingrid Diederen Phd Pa 172 Asheland Ave Suite D Asheville NC 28801-4005 Ph: (828) 253-1445 |
| NPI Number | 1114229275 |
|---|---|
| Provider Enumeration Date | 11/23/2010 |
| Last Update Date | 11/23/2010 |
| Medicare PECOS PAC ID | 9436347499 |
|---|---|
| Medicare Enrollment ID | O20101217000715 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114229275 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 1376 (North Carolina) | Primary |
| Provider Name | Ingrid M Diederen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932267887 PECOS PAC ID: 8921064874 Enrollment ID: I20041202000913 |
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