Agresta, Diane Marie
Agresta, Diane Marie is an sole proprietor health care provider with primary practice located at 321 S Main St Suite 209, Ann Arbor MI 48104-2117. She recently has 7 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Adult Development & Aging, Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Family, Behavioral Health & Social Service Providers / Group Psychotherapy. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Agresta, Diane Marie can be contacted via phone (734) 665-9890.Contact Information
Primary practice address
321 S Main St Suite 209
Ann Arbor MI 48104-2117
Phone: (734) 665-9890
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 6301002761 | Michigan |
| Behavioral Health & Social Service Providers / Adult Development & Aging | 103TA0700X | 6301002761 | Michigan |
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | 6301002761 | Michigan |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301002761 | Michigan |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 6301002761 | Michigan |
| Behavioral Health & Social Service Providers / Family | 103TF0000X | 6301002761 | Michigan |
| Behavioral Health & Social Service Providers / Group Psychotherapy | 103TP2701X | 6301002761 | Michigan |
Profile Details
| NPI number | 1114973310 |
|---|---|
| LBN Legal business name | Agresta, Diane Marie |
| Credentials | PSY.D |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 26th, 2006 |
| Last updated | Jun 10th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114973310 | NPPES |
| Michigan | Other | 620H14705 | BXBS PROVIDER NUMBER |
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