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General NPI Number Information
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NPI Number | 1568986636
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Entity Type | Individual
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Provider Name | DIA AUSTINE MAJETT RONEY
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Gender | Female
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Dates
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Enumeration Date | 07/31/2017
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 6502 GRAND TETON PLZ STE 102
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City | MADISON
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State | WI
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Zip | 53719
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Country | US
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Telephone | 913-293-9775
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Fax |
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Provider Business Mailing Address
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Address Line | 6627 WOLF HOLLOW RD
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City | WINDSOR
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State | WI
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Zip | 53598-9813
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Country | US
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Telephone | 913-293-9775
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0013919
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7424-125
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License Number State | WI
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