Prosser, Diane Johnson
Prosser, Diane Johnson is an sole proprietor health care provider with primary practice located at 227 N Dixie Way Ste 110 , South Bend IN 46637-3366. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Prosser, Diane Johnson can be contacted via phone (574) 850-8486.Contact Information
Primary practice address
227 N Dixie Way Ste 110
South Bend IN 46637-3366
Phone: (574) 850-8486
Fax: (574) 966-1585
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20040993 | Indiana |
Profile Details
| NPI number | 1952452534 |
|---|---|
| LBN Legal business name | Prosser, Diane Johnson |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 12th, 2007 |
| Last updated | May 16th, 2016 - about 8 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 | 1952452534 | NPPES |
| Indiana | MEDICAID | 200122760A |
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