Individual
TRACY A DIEHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
570 DEVONAIRE PKWY, DEKALB, IL 60115-8502
(815) 761-3382
Mailing address
570 DEVONAIRE PKWY, DEKALB, IL 60115-8502
(815) 761-3382
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/19/2022
Last updated
02/19/2022
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