Healthcare Provider Details

I. General information

NPI: 1992016752
Provider Name (Legal Business Name): DIANA FEHR LPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2010
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 EASTCHESTER DR STE. 200
HIGH POINT NC
27265-3170
US

IV. Provider business mailing address

1701 WESTCHESTER DR STE.850
HIGH POINT NC
27262-7008
US

V. Phone/Fax

Practice location:
  • Phone: 336-802-2205
  • Fax: 336-802-2206
Mailing address:
  • Phone: 336-802-2536
  • Fax: 336-802-2534

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3678
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3678
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: