Individual
DIANE C WHITLEY FELDMAN
Active
Individual
DIANE C WHITLEY FELDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.DL
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP0806
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04420FE
BCBS PROVIDER NUMBER
MN
01
—
LP0806
MN BOARD OF PSYCH LICENSE
MN
Enumeration date
08/10/2005
Last updated
09/10/2008
Update your record
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