=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023399730
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DIANNE MARIE ATTEBERRY TLMFT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2011
-----------------------------------------------------
Last Update Date | 09/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9219 W 140TH TER
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66221-2025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-956-9500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9219 W 140TH TER
-----------------------------------------------------
City | OVERLAND PARK
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66221-2025
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-956-9500
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | 1258
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------