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Individual

THOMAS LEO DIANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
66 E 3RD ST, WINONA, MN 55987-3478
(507) 452-1021
(507) 452-1504
Mailing address
66 E 3RD ST, WINONA, MN 55987-3478
(507) 452-1021
(507) 452-1504

Taxonomy

Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
LP1219
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
126921
UCARE
MN
05
200048200
MN
01
731291041000
PREFERRED ONE
MN
01
78G63DI
BCBS-MN
MN
01
HP41036
HEALTHPARTNERS
MN
Enumeration date
12/06/2006
Last updated
01/22/2010
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