Organization
DIEFFENBACH COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN PAUL DIEFFENBACH LICSW (CHIEF MANAGER)
(651) 338-9435
Entity
Organization
Contact information
Practice address
2368 JOY AVE # NA, WHITE BEAR LAKE, MN 55110-7409
(651) 338-9435
Mailing address
2368 JOY AVE # NA, WHITE BEAR LAKE, MN 55110-7409
(651) 338-9435
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
09/11/2023
Last updated
11/13/2024
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