Healthcare Provider Details

I. General information

NPI: 1225250962
Provider Name (Legal Business Name): KALYN DIAMOND PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KALYN DIAMOND PH.D.

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 12/16/2020
Certification Date: 12/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

942 SW WOODBRIDGE CT
TOPEKA KS
66606-4600
US

IV. Provider business mailing address

942 SW WOODBRIDGE CT
TOPEKA KS
66606-4600
US

V. Phone/Fax

Practice location:
  • Phone: 785-806-3328
  • Fax:
Mailing address:
  • Phone: 785-286-7400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number1738
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number1738
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number1738
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number1738
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: