Individual
DR. DIANE LOUISE STELLRECHT
Active
Individual
DR. DIANE LOUISE STELLRECHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LP
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
1130
MN
103TC0700X
Clinical Psychologist
1130
MN
103TC0700X
Clinical Psychologist
Primary
LP1130
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28682ST
BCBS
MN
05
—
588350400
—
MN
Enumeration date
08/06/2007
Last updated
12/22/2021
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