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Individual
ABBEY J DIECKMAN
Active
Individual
ABBEY J DIECKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15717-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15735-131
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427322759
DEANHEALTH PLAN
WI
05
—
1427322759
—
WI
01
—
MALOMABB
MERCYCARE INSURANCE
WI
Enumeration date
03/05/2012
Last updated
02/01/2021
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