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General NPI Number Information
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NPI Number | 1659319069
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Entity Type | Individual
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Provider Name | DUANE MICHAEL DIAN PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6000 W HIGHWAY 98 ATTEN. SARP
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City | PENSACOLA
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State | FL
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Zip | 32512-0001
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Country | US
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Telephone | 850-452-6776
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Fax | 850-452-6025
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Provider Business Mailing Address
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Address Line | 840 AMBERWOOD DR
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City | PENSACOLA
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State | FL
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Zip | 32506-7611
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Country | US
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Telephone | 850-458-1241
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 305
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License Number State | HI
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