Whitehead, Diane Louise

Whitehead, Diane Louise is an individual health care provider with primary practice located at 607 Baxter St Fairview Ass., Johnson City TN 37601. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Whitehead, Diane Louise can be contacted via phone (423) 232-2670.

Contact Information

Primary practice address
607 Baxter St Fairview Ass. Johnson City TN 37601
Phone: (423) 232-2670
Fax: (423) 928-0381
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PHD 425 Tennessee

Profile Details

NPI number 1396857322
LBN Legal business name Whitehead, Diane Louise
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 21st, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396857322 NPPES
Other 119750 ANTHEM PROF TRIGON
Other 334969 ANTHEM PROF TRIGON
Other 0106607 ANTHEM PROF TRIGON
Other 119750 ANTHEM PROF TRIGON
MEDICAID 3980891 ANTHEM PROF TRIGON
Other 0106607 ANTHEM PROF TRIGON
Other 0106607 ANTHEM PROF TRIGON
MEDICAID 3689293 ANTHEM PROF TRIGON
Other 7692240 ANTHEM PROF TRIGON

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