Healthcare Provider Details

I. General information

NPI: 1952179202
Provider Name (Legal Business Name): DIEHL & DIEHL PSYCHOLOGY, SPEECH, AND PERFORMANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 CLINTON PARKWAY CT STE 201
LAWRENCE KS
66047-2657
US

IV. Provider business mailing address

3300 CLINTON PARKWAY CT STE 201
LAWRENCE KS
66047-2657
US

V. Phone/Fax

Practice location:
  • Phone: 720-619-0531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ROBERT DIEHL
Title or Position: CO-FOUNDER/PSYCHOLOGIST
Credential: PHD
Phone: 203-984-2781